When to See a Doctor for Migraines and What Tests to Expect

If you're experiencing a migraine for the first time or noticing significant changes in your pain patterns—such as a shift from a pulsating pain on one side of the head to a sudden explosive headache, or from daytime discomfort to being woken up at night by pain—it's time to visit a neurologist. These changes could indicate underlying issues that require further investigation. Neurologists typically recommend a series of imaging and diagnostic tests to rule out serious conditions and confirm migraine-related causes.

Common Diagnostic Tests for Migraine Patients

1. Magnetic Resonance Imaging (MRI): An MRI scan provides detailed images of the brain and can help detect abnormalities such as tumors, bleeding, or signs of stroke. This non-invasive test is often preferred over CT scans due to its higher resolution and lack of radiation exposure.

2. Magnetic Resonance Angiography (MRA): This specialized MRI scan focuses on the blood vessels in the brain. It helps identify potential life-threatening conditions like aneurysms or vascular malformations that could be contributing to migraine symptoms.

3. Computed Tomography (CT) Scan: While less detailed than an MRI, a CT scan can quickly detect major brain abnormalities such as hemorrhages or structural issues. It is often used when MRI is not immediately available or necessary.

4. Transcranial Doppler (TCD) Ultrasound: This test evaluates blood flow velocity in the brain's major arteries. It is particularly useful in identifying cerebral vasospasm—a known factor in migraine pathophysiology—which can cause increased blood flow speed and contribute to headache episodes.

Why These Tests Matter

Each of these diagnostic tools plays a crucial role in understanding the underlying causes of migraines. By combining clinical evaluation with advanced imaging techniques, doctors can ensure accurate diagnosis and tailor effective treatment strategies specific to each patient's condition.