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What is a "vasodilator"

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Post  tinalouise Tue Aug 10, 2010 11:02 am

I just read something on here about magnesium being a "vasoldilator". I am assuming, maybe incorrectly that it means the widening of the arteries in one way or another and I thought that was a good thing but after reading some of these posts someone showed concern in a negative way about it. I started taking Calcium Magnesium and Zinc about a month ago after a doozy of a migraine and I haven't had one since so I am hoping there is a correlation. If someone could please help me out here I would appreciate it.

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Post  jwar Tue Aug 10, 2010 2:20 pm

Vasodilator just means the widening of blood vessels, and the mechanism behind this is generally the relaxation of smooth muscle cells.

For a long time it was believed that migraines were a direct result of vasodilation and therefore a disease of blood vessels. Nowadays, they realize that migraines are a disease of the brain and that vasodilation may just be part of the phenotype of migraine and not the cause. In general during a migraine the blood vessels in your head become very dilated, and this causes them to press on surrounding nerves which results in pain.
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Post  tinalouise Tue Aug 10, 2010 3:43 pm

Now I understand why it would be negative thing in relation to migraines. I heard that magnesium is suppose to be good for headaches in general but I am not too sure about for migraine headaches. So far so good though. Thanks for the information.

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Post  jwar Tue Aug 10, 2010 3:45 pm

The point is that the vasodilation theory of migraines is out-dated and has been replaced by the reality that migraine is a disease of the brain, not of blood vessels. So taking magnesium/niacin/etc, which are natural vasodilators, shouldn't be a problem. It is widely accepted that magnesium is good for migraineurs and most - if not all - neurologists will recommend that patients take it.
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Post  tinalouise Tue Aug 10, 2010 3:58 pm

Thanks for sharing your knowledge, it is much appreciated. It is scary to think I have a "disease of the brain" though I must be honest. I will stay positive and just do what I can to keep the migraines at bay the best that I can. That is all any of us can do I suppose.

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Post  jwar Tue Aug 10, 2010 3:59 pm

It's very hard for me to accept that I have a neurological disease, as well. Especially a progressive one that has no cure.

I think this forum is a really helpful place in that there are many people here that truly understand what each other must go through on a daily basis. While it doesn't provide a cure, it's at least an outlet for frustration and sharing.
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Post  Guest Tue Aug 10, 2010 7:21 pm

I don't think migraine is entirely a neurological disease, but I agree it certainly has neurologic effects. If you do have vasoactive issues, then you may get migrainous headaches.

I don't think it's totally old school thinking, but part of the many building blocks of migraine. As I'm sure we all know, everyone's migraine is different. I think if you have a vascular family history, your doc is going to go down that path--and moreso if you're responsive to the vasoactive meds out there.

If you're a "vasculopath" as some docs call their patients with significant vascular disease, then you know the effects of vasodilators....

Betas, calcium channel blockers, ACE, ARBs, nitrates are all part of your arsenal.

The health of the vascular beds are considerably important.

One of the more uncomfortable things in life is having a stroke, that gives you a significant headache. Then having IV nitro & heparin for a few days after. Not pleasant, especially with permanant damage. Yes, the neuro side comes in after the disruption of blood supply.
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Post  TeriRobert Tue Aug 10, 2010 9:45 pm

Actually, it has now been proven that the "neuro side" comes into play before any vascular changes. The whole neurological process of cortical spreading depression is what causes the vascular issues, changes in neurotransmitter levels, and the other parts of the Migrainous process.

Probably 10 years ago, this was theory. It has now been proven, repeatedly.

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Post  Guest Tue Aug 10, 2010 10:08 pm

Teri,

Does CSD happen more with migraine patients with aura?

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Post  tinalouise Wed Aug 11, 2010 8:16 am

My mother has arteriosclerosis and has since passed away from complications from it so I am assuming that can be hereditary. I don't smoke(mother smoke and drank) and drink rarely and I try to exercise but who knows if even that will help if one is predisposed to a certain genetic disease.

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Post  Guest Wed Aug 11, 2010 9:16 am

Just about everyone is in one stage or another of atherosclerosis. Some are worse than others given their genetic disposition.

Some people have normal as some of my cardiologists call it "old fart" atherosclerosis and deposits of plaques throughout their entire vascular system (this just doesn't affect the heart, it's through everything in your body, including tiny microvessels that you can't see).

true diet, excercise, and diabetes can significantly influence the degree of disease in the vessels, however those that are genetically programmed are a different story.

if you're genetically predispositioned for a significant lipid disease there are only a few things out there that can help. statins, some meds that keep cholesterol from being absorbed in the digestive system, apheresis (filtering), and maybe niaspan to help overal elevate HDL.

out of all the statins out there right now, one of them is by far the most powerful and shows the most promise to slowing plaque build-up...it can act as liquid plumber in high doses but significant risk to neuromuscular damage.

endothelial dysfunction in the vessels can cause a whole host of issues and help along the entire process including vascular disease, which does influence bad head pain.

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Post  tinalouise Wed Aug 11, 2010 10:43 am

I am impressed with your knowledge and truly appreciate it. I guess I just worry about the stroke/migraine connection because I do remember my mother also having the aura/migraine and always seemed to have a headache and she did have a mild stroke. I don't usually get headaches in general but will get the aura/mild migraine, feeling drained type headaches.

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Post  Guest Wed Aug 11, 2010 12:58 pm

thanks tina,

there's a lot of really bright people on board here. i'm trying to brush up again on the neuro side...on the cardiovascular side, it's really important to stay on top of things for me.

i'm interested too in the migraine/stroke connection. i don't usually have aura--when i do it's quite strange...i can't read and it seems like portions of the paper are moving up and down. i think one of the migraine docs i saw called it fisheye migraine. don't quite remember.

i had a stroke that really had a lot of migrainous effects including paralysis. it had a lot more stroke than migraine to it, and the neuro in the hospital that saw me missed a lot of things despite being an obvious stroke risk. he felt since i had migraines, it was more likely that it was migraine rather than a vascular accident (duh, i have all the cardiac risk factors, and a known cardiac events).

memory is an important part in this too. i have a few docs that are keeping track of the problems. only downside is sometimes the wait time to get in.

my docs won't take me off plavix & aspirin for cardiac and stroke risk, despite the risk of a bleed. we feel there's more of a chance of a blockage.

good luck!

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Post  tinalouise Wed Aug 11, 2010 2:03 pm

Sorry to hear about your stroke but the good news is you are still here and it seems as if it did not have a serious outcome which is always good. At the time of the stroke did you think you were just having another migraine or was it different?
My last migraine/aura was so bad I almost went to the ER and I am not sure how to know, if that time comes, whether to wait it out or actually go to the ER because it is something more serious.

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Post  Guest Wed Aug 11, 2010 2:25 pm

stroke was not fun....it's been almost 4 years with permanent lasting results, but you're right i'm still alive.

first inkling that something was wrong was a severe stabbing headache, some flashes of light, and confusion. sounds like typical migraine.

had neuro symptoms...drooping side of face, slurred speech, couldn't lift brows, problems coordinating walk.

i had more neuro symptoms about a day after the first symptoms. went to ER--i thought it was a normal migraine.

some moron ER tech misclassed me and i sat for 4 hours. my dad went up to triage and stirred up a tornado. i was taken back, given a CT, then tPA to start clot busting. ER doc thought it was a stroke.

long story short, still problems with left side of face (numb sensation that wraps from my skull, into my cheek, nose). gets worse with stress. left eye lost a section of vision, but came back. nailed my depth perception (i was a bad golfer before, but worse after). caused some some other stuff.

stupid neurologist ordered MRs late in the process, and didn't order them with and without. so we know it's a CVA that was resolved with meds and cleared out, but the residual injuries stayed. post MRs are good, so no fixed blockages in the large vessels. something blocked, did its damage, and cleared out.

i always had most of my migraines on the right side of my head. after the stroke, it flipped them to the left side. very annoying. and i type "dyslexic" now.

anyone that thinks that it's a possibility of a stroke should go in. it's dumb to sit around and wait. if a migraine is any different than what you are used to, get into the ER.

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Post  tinalouise Wed Aug 11, 2010 2:33 pm

If you do not mind me asking, how old were you when this happened and was there any other factors involved such as smoking, high blood pressure, genetics? I also read a post on here where the woman stopped having her aura's with her migraine after she had a stroke. Coincidence? Who knows but I guess the lesson is to be vigilant and unlike my mother I don't smoke and drink only occasionally.

Do you ever find yourself worrying about the "next migraine"? I always do and it is frustrating to say the least. Trying to get over the obsession of it but it will take time.

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Post  Guest Wed Aug 11, 2010 5:09 pm

I don't worry about having a stroke from a migraine. I have a constant brainache all day--it just changes in intensity. I take enough meds to balance and control them, and pain meds to take down the worst ones.

I have especially bad genetics...stroke and cardiac risk factors rather severe from both sides of the family. I would not compare my situation as near normal to any other migrainuers here. My case weighs heavily on extreme genetic risk factors. I do have high blood pressure (another nasty genetic kidney issue) but is extremely well controlled with medication. I was 29 at the time.

I have never smoked. I very seldom drink. We have a very good reason why I had that event. I had an upper GI 3 days before the CVA and had to stop my protective medication which is Plavix and Aspirin.

If I have to stop medications (the only way that would happen is if the world melted down or some other massive health reason) that treat my cardiovascular problems, that's the only time I worry about stroke risk. If you follow the regimen, do what you can, then it's just self defeating to worry about something that could go boom. Chances are some day it will go boom, so enjoy life while and if you can.


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Post  tinalouise Thu Aug 12, 2010 9:30 am

29 is quite young for a stroke, did you have high blood pressure that you knew of before the stroke and do they know what caused it in the first place? For instance, my mother's carotid artery was apparently clogged which in turned caused her mini stroke. I wonder if taking a baby aspirin a day would be helpful in the long run, if my stomach can handle it i may try it.

Thanks for all of the information, I appreciate it.

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Post  Guest Thu Aug 12, 2010 11:31 am

Tina,

Blood pressure is controlled....~100/60. Without medication, it would be uncontrolled. At the time of the stroke, it was and is stable and controlled.

We do think it was stopping aspirin and Plavix for a procedure that triggered the event.

I do take 81mg (baby aspirin) every day and Plavix, a med that helps keep platelets from sticking together causing a clot.

You should talk with your doc about starting aspirin--have to make sure as you pointed out that it won't cause stomach issues.

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Post  dawn.binks Sat Aug 14, 2010 12:52 am

i too had a stroke at 31 caused by chiropractic treatment for migraine and tina louise the pain is totally different to migs its like 100 migs in one go and you get loads more neuro symptons but i too like porsche wouldnt worry about the link between mig and stroke because yes theye is an increased risk bt it is very low and other things are higher risk eg drinking smoking overweight genetic etc.
since the stroke i dont complain about migraine having endured he pain of stroke!
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Post  tinalouise Sat Aug 14, 2010 11:28 am

I am seeing a pattern here I do believe or is it just a coincidence that many with migraines have strokes?
I have also wondered/worried about chiropractic treatment as well and haven't gone in years because it did not seem to help in any way for me and I can see the connection to stroke being somewhat obvious. The good news is you are a stroke survivor and for that we are grateful!!

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Post  dawn.binks Sat Aug 14, 2010 2:18 pm

hi tinalouise, dont worry about any patterns here, there isnt eonough to say that many who have migs have strokes, just focus on healthy living and avoid chiropractors!!!!!!!!!
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