More than 37 million Americans suffer from migraine. This vascular headache is most commonly experienced between the ages of 15 and 55, and 70% to 80% of sufferers have a family history of migraine. Less than half of all migraine sufferers have received a diagnosis of migraine from their healthcare provider. Migraine is often misdiagnosed as sinus headache or tension-type headache. Many factors can trigger migraine attacks, such as alteration of sleep-wake cycle; missing or delaying a meal; medications that cause a swelling of the blood vessels; daily or near daily use of medications designed for relieving headache attacks; bright lights, sunlight, fluorescent lights, TV and movie viewing; certain foods; and excessive noise. Stress and/or underlying depression are important trigger factors that can be diagnosed and treated adequately.

Although a 2008 NHF web survey determined that 23% of respondents claim to suffer from sinus headache, research concludes that that “stuffy nose and dull head pain” should may actually be migraine or another form of vascular headache. A large majority of sinus headache sufferers actually experience some form of a vascular headache. The enlargement of blood vessels typically causes vascular headaches, which include migraines, cluster headaches, and toxic headaches.  Typically, the sufferer feels throbbing head pain that is intensified by physical exertion.

Q. I read the article on hemiplegic migraine on the NHF Web site and found it very interesting. I have had hemiplegic migraines my whole life. I suffer from all four phases (prodrome, aura, headache and postdrome), which can last up to a week. I go completely blind, deaf and mute, and am paralyzed on my right side. Half the time I become comatose. On two occasions I have gone into cardiac arrest during these migraines. My doctor prescribed the triptan Imitrex® and it is the only drug that will stop these terrible attacks. I noticed that your article said that I shouldn’t take triptans. Why not?

There is a form of ergotamine available for Injectable use under the trade name of D.H.E. 45®, and by inhalation under the trade name of Migranal®. It is useful in the acute treatment of migraine and other vascular headaches such as cluster headache. The Injectable form is usually given as intramuscular medication, but can also be given intravenously or subcutaneously. To be effective in aborting a migraine attack, it should be given as early as possible into the headache. Follow-up doses may be needed in some patients.

Vasodilation of the blood vessels may be caused by consumption of, or exposure to, nitrates and nitrites, which may trigger a vascular headache. Nitrates are found in some medications for heart problems and in some chemicals used in the food and beverage industry. The nitrites are used...