Headaches can range on the pain scale from annoying to debilitating, but do share one important trait: They make you feel like mushroom fertilizer - and except to pigs, that's not a beautiful sight.
Much of the biology of headaches stems from the function of a nerve that sounds like the name of a Jedi knight. The trigeminal nerve is a large nerve that comes directly from the brain and divides into five branches to cover the face. A variety of triggers stimulate inflammation and irritation of this nerve and surrounding tissues. And that erupts into the pain we sense as a headache. Another major cause is a dilation of blood vessels. Too large blood vessels can be painful themselves or can cause pain by allowing various chemicals to ooze slowly out of the blood vessels and seep into the tissues around and in the brain and cause inflammation.
About 15 percent of us are born with small holes in our heart. If those holes don't close, blood shunts right past the lungs to the brain. (If they don't close naturally, they can be subsequently closed with a procedure using a groin catheter, in which an umbrella-shaped device is fed up through the body and covers the hole.) Maybe you didn't know it, but the lungs serve to detoxify and clear a lot of bad chemicals from the blood. Without going through a detoxification process in your lungs, those chemicals can go right to the brain to trigger headache pain by dilating brain arteries.
During a headache, levels of the feel-good chemical serotonin drop. This may cause the trigeminal nerve to release substances called neuropeptides, which cause blood vessels to become dilated and inflamed. In migraines, serotonin first elevates, then drops - making you even more sensitive to pain. Migraine medications mimic serotonin so cells can use it more effectively, and they also stop the release of those neuropeptides to prevent the dilation of blood vessels.
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