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Status migrainosus is a migraine headache of more than 72 hours duration. In addition to being extremely unpleasant for patients, these migraines come with increased risks of complications. There are treatments available, including drugs designed to be taken in the first hour to break the headache, as well as supportive therapies to keep a patient comfortable for the duration of the headache if it cannot be broken. Patients who have experienced a migraine of this nature are usually referred to a neurologist for care if they are not seeing a neurologist already.
In a migraine headache, patients experience high intensity pain, usually isolated to a specific region of the brain, although not always. The pain can feel throbbing in nature, and patients often experience sensitivity to light and/or sound, along with symptoms like nausea and vomiting. Migraine headaches are understood by the medical community to be manifestations of ongoing neurological problems and they can be managed with medication and other therapies.
Migraines usually last less than 72 hours. When they exceed this duration, they are considered status migraines. One major danger with status migrainosus is that it increases the risk of stroke for the patient. Migraines are associated with dilation of the blood vessels and if this persists for an extended period of time, it can lead to ruptures and hemorrhagic stroke. In addition, patients with status migrainosus often develop dehydration because of vomiting and lack of interest in food and drink. This can create additional complications for the patient.
If a migraine is identified early, medications can be administered to prevent the onset of the headache. Patients with a headache already well established can be given treatments like intravenous fluids to address dehydration along with analgesia for the pain. The patient is also carefully monitored for signs of stroke. When the status migrainosus breaks, additional clinical evaluations may be recommended to learn more about why the patient developed status migrainosus.
Migraine treatments can themselves contribute to migraines in some cases, as some medications can lead to headaches when they are taken in the long term. It is important to regularly adjust a treatment regimen to reduce the risks of developing medication tolerance and other problems. If a patient is no longer responding to treatment, adjustments can be made to provide the patient with access to new medications for migraine management and prevention. Long term care requires consistent follow-ups with a neurologist to assess the patient's overall level of health and neurological function.
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