If you have episodes of migraine, you know that they’re more than severe headache pain. This common neurological condition affects more than 40 million people in the United States, including young children.

However, many people with migraine don’t get diagnosed.

In most cases, a healthcare professional will diagnose this chronic medical condition by looking at your symptoms and medical history as well as conducting a physical exam.

You don’t need to get an imaging scan to diagnose migraine, but your doctor may recommend getting an MRI in certain cases.

We’ll discuss why getting this kind of imaging test may help with a migraine diagnosis and what a neurologist looks for on an MRI scan for migraine.

Your doctor might recommend an MRI scan of your brain if you have severe migraine episodes, and:

  • they’re not getting better with treatment
  • you have other symptoms

An MRI scan uses radio waves along with a strong magnetic field to produce clear images of the inside of your body.

They differ from X-rays and CT scans because MRIs don’t use radiation to form the images. A contrast dye (that you drink or that’s injected) may be used before or during the test to get a sharper image of the area being scanned.

With an MRI for migraine, your doctor will look at your brain to see whether there are any changes to the regular brain structure.

However, MRI scans aren’t always used to diagnose migraine. Researchers aren’t yet certain whether changes in the brain lead to migraine episodes or whether everyone with migraine episodes has similar brain changes. Studies on MRIs for migraine are ongoing.

What an MRI scan can do is give a very detailed image of the brain and show areas that can’t be seen with other kinds of imaging scans. This can help your doctor rule out other causes of migraine or headache pain.

In some people with migraine, MRI scans of the brain may show white spots or areas. These are caused by lesions or irregular areas in the white matter of the brain. White matter tissue is deep in the brain and is mostly made up of nerves.

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J Headache Pain. 2014; 15(1): 41.J Headache Pain. 2014; 15(1): 41. Published online 2014 Jun 19. doi: 10.1186/1129-2377-15-41

Everyone has some tiny brain lesions — they’re a normal part of aging. They can happen when blood flow is reduced or stopped to a small area of the brain. This can damage some brain cells, causing a lesion.

Researchers aren’t sure why people with migraine have these lesions. These lesions seem to be more common in people who experience migraine with aura.

Chronic or severe migraine may cause more lesions than normal in some people. However, the white matter lesions don’t cause migraine symptoms. Researchers say that they’re also not linked to dementia or memory loss in older adults.

Medical researchers also use MRI scans of the brain to help find out why migraine episodes may happen in some people and not in others.

In one study from 2015, researchers looked at how the brain responded to sight, smell, and pain stimulation. They found that people with migraine may have irregular or more sensitive brain responses to normal stimuli.

MRI scans are often used to help diagnose migraine because they can provide a complete and detailed picture of the brain’s structure. They’re also used to research the cause of migraine and the effects on the brain.

Other kinds of imaging tests that might be used in diagnosing or studying migraine headaches include:

  • X-ray. An X-ray isn’t commonly used to diagnose migraine. Your doctor may order a head X-ray if you’ve had a recent injury or trauma to the head or face that may be causing headache pain. In some cases, doctors will use X-rays along with CT scans to get a better picture of the skull and brain.
  • CT scan. A CT scan may be recommended by your doctor to rule out certain medical conditions that may be causing headache pain. These underlying conditions include brain tumors, sinus blockages, brain aneurysm, brain bleed, and stroke.
  • Magnetic resonance angiogram (MRA) scan. An MRAnis similar to an MRI scan. It differs from an MRI because it mainly shows irregularities in the brain’s blood vessels such as an aneurysm or a clot.

Migraine is a common and treatable type of headache pain. However, it’s typically long-lasting and chronic.

Most people with migraine have episodes that last for about 4 hours. Without treatment or in severe cases, a single migraine episode can last from 72 hours to a week.

Your doctor may recommend trying a few different medications to find one that is right for you. For some people, over-the-counter pain medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are the first line of defense in treating migraine.

Lifestyle changes and avoiding your migraine triggers (if you can pinpoint them) may also help. Changes that might provide migraine relief include:

Let your doctor know if your migraine episodes don’t improve with lifestyle changes and over-the-counter medications. You may need prescription medication and a medical checkup with an MRI for migraine.

When to go to the hospital

Seek emergency medical attention if your migraine causes severe headache pain or if you have other symptoms, such as:

  • pain that gets worse
  • pain that doesn’t get better after a few hours
  • weakness on one side of the face or body
  • pain that comes on suddenly and severely

You may need an urgent scan to find out what’s causing serious or unusual cases of migraine or headache pain.

Migraine is a common cause of headache pain that can cause varying symptoms. Experts aren’t exactly sure why some people have migraine or what causes these episodes.

While you don’t need an imaging scan for migraine diagnosis, MRI can be a useful tool in some cases. These brain scans can also help researchers study migraine and how it effects the brain. Hopefully, this will help lead to new ways to treat or prevent migraine in the future.