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Headache and Migraine Causes?
Blog January 19, 2025

Headache and Migraine Causes?

Dr. Yeonseung Choe
Dr. Yeonseung Choe
Chief Director

Over the past several decades, extensive research into the mechanisms of headaches and migraines has significantly advanced our understanding. Now, let's delve into why headaches occur and what factors can trigger them.

Why Headaches Occur

Migraine and Episodic Ataxia Type 2

To explain how headaches occur, nerves innervating the blood vessels surrounding the meninges and dura mater continuously receive signals. The trigeminal ganglion primarily receives and interprets these signals. If excessive stimulation is transmitted at this point, the signals relayed from the trigeminal ganglion are perceived as pain—a headache. Environmental changes around the skull, such as vasodilation or inflammation, transmit signals from the meninges and blood vessels to the nerves, leading to the sensation of pain. However, the interpretation of these pain signals is complex, as it is co-regulated by various other factors.

The Enigma of the Dorsolateral Pons as a Migraine Generator

Signals are transmitted from the dura to the trigeminal ganglion, but subsequently, ascending signal transmission occurs to the thalamus. During this process, various areas of the brain stem modulate the signals, either amplifying or suppressing them. Normally, when the brain stem is inactive, signal transmission to the thalamus is weak and not perceived as pain or a headache. However, if the brain stem becomes activated due to dysfunction, strong signal transmission occurs, triggering a headache.

Neurochemical Pathways That Converge on Thalamic Trigeminovascular Neurons

The regulation of headaches is not solely due to the state of the meningeal area; rather, the pain threshold can be observed to fluctuate due to the combined action of a wide array of factors. Food, somatic pain, anxiety, depression, cognitive tasks, sleep status, stress, and negative thoughts can all induce these changes. When multiple factors accumulate and surpass the pain threshold, a headache is triggered.

Summary

  1. Headaches are not caused by a single factor but rather by the combined action of highly complex reasons.
  2. Factors such as various forms of stress, emotional responses, overwork, mental strain, lack of sleep, irregular meals, light, and noise can exacerbate headaches when they come into play.

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Dr. Yeonseung Choe

Dr. Yeonseung Choe Chief Director

I have met many patients who came after visiting multiple medical institutions and departments for persistent or recurrent conditions. Symptoms normally handled by different specialties—such as abdominal pain, headaches, palpitations, dizziness, and insomnia—may overlap in one person. Sometimes there is no clear improvement despite taking medication for each symptom, and being unwell gradually becomes part of daily life. In these cases, I look beyond individual diagnoses and examine how the symptoms connect and change together. Asking only about the most uncomfortable symptom today does not reveal the full course. I look at when the body first began to change and what happened after illness, surgery, childbirth, or starting and stopping medication. I also review changes in weight, diet, and sleep, then trace which symptoms improved with previous treatment and which remained. Test results, diagnoses, and the course of previous treatment are important for understanding the current condition. Clinical research in modern Korean medicine, physiological and pathological research in modern medicine, and observations recorded in classical Korean medicine texts offer different perspectives on the same body. Rather than fitting a patient into one perspective, I consider what each can and cannot explain and look for clues that connect symptoms and treatment histories that were previously considered separately.

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