Preventive Medication and the American Migraine Communications Study

This is an good article, but even going to the top headache clinic that everyone on this site would know if I mentioned was the biggest nightmare of my life. They treated me horribly and all the things I did for my local neuro were looked at as my being fixated on migraine and pain... (migraine diary, etc). I was in my early 20's accepted to top grad schools. I was so sick though I was in and out of inpatient constantly and it all started after a bad injury to the head/jaw. The psychs had a hayday with me. They were distressed when I talked about medications and had working knowledge - that happens when you have had pharmacology. Being an informed patient made my stay so bad that they finally decided I was a histrionic, narcisistic mess and that it was in my head psychologically...lots of money and three weeks later I came home exhausted in tears only to be told by a local psych I went to see over how upset and distressed I was by the way I was treated and how at that point I thought I didn't know how to handle anything related to migraine that I was one of many patients he'd seen that had been to this prestigious clinic only to be told this when they couldn't fix the problem. I was a lab rat for this clinic and treated so badly that I was yelled at after a surgery when they forgot to administer steroids for inflammation and then ended up giving me one shot of Nubain due to severe pain. It was terrible and trying to help them understand how it was impairing me was unfortunately the very worst thing. In an ideal world or a perfect one the docs would listen and see that if you are missing classes and you are a highly motivated student working extremely hard to be in school then it just doesn't make sense that your faking, fixated, or just histrionic. I have taken the MMPI a few times and always comes back the same "patient is having real daily pain" this is what the psychs say, except when I took the very same test at their clinic -- interesting? While acknowleding that there are some therapies that help, sometimes just talking it out, if the person you are dealing with seems to be predisposed to looking for people that malinger....your up a creek. I came back to my local neuro and that is who I have had the most help from. Every referral out to other specialists ended in the doctor accusing me of drug seeking or other things because they simply didn't get it. I'd like to think you could take your migraine chart to these pain docs, but I'd never do it. NEVER. The only doc I would let know how truly impaired I am by migraine is the one I have had for nine years since my injury. The rest put me in tears and struggling with the migraines are enough, you don't need added stress. So I think we need a lot of doctor education even amongst our so called TOP experts who failed me miserably because they couldn't look at the MRI and CT to see the damage and the extensive surgery -- they just couldn't, so when you have hard evidence of a situation that starts the migraine, then your having them, and they still can't listen, that is not a patient problem that is a physcian issue and it is unfortunate that these clinics seemed to treat not only me but many others the same way. I think they like the easy cases that the basic neuro doesn't fix and they do so it makes them look fantastic, but if your too complex for them it is all in your head. 

Oh, and Topamax -- it is the closest thing to a cure for me. Clearly, they could have helped. They were to busy looking for a malingerer when I shared how I was impaired. Once bitten, twice shy!

I am not a clinician, but I can tell you from personal experience that periodic migraines can follow a concussion.  I suffered a concussion at age ten (44 years ago).  I never had migraines before the injury, but have had periodic migraines since that time.  As in your case, I suffer from migraines with aura.

There seems to be no real pattern or particular trigger to my migraines. I have exeperienced occasional periods without them, e.g., I never had one while I was an undergraduate in college.  Generally, though, I begin to get symptoms a few times a year.

In my case, I don't need prescription medication to deal with the migraines.  I have found that I can take aspirin when I notice the aura, and it will dramtically reduce the intensity of the headache (acetominophen doesn't seem to be as effective, and aspirin doesn't completely eliminate the headache).  If I don't take an off-the-shelf pain reliever until after the migraine starts, the analgesic will be ineffective.