This type of test is often not needed if the headache description fits the diagnosis of migraine, the neurological examination is normal, and the person's age and other factors do not suggest another diagnosis. Patients often need the evaluation of a physician, who is best able to judge whether a test would be helpful, when headaches first start or when mild headaches suddenly become more severe or more frequent. Migraine headache is thought to be a genetically inherited disorder strongly influenced by environmental factors. A person may inherent a predisposition for developing migraine headaches, but other factors such as stress, hormonal changes, or sleep disturbances are necessary to experience a migraine. Pathophysiology or abnormalities in the body that cause migraines are still not known.
Several theories exist, but none has been proven to be the sole cause of migraine.
More research is needed to truly understand the mechanisms of migraine headache. Most patients develop their first migraine headache in adolescence or early adulthood. Many women report that headaches worsen before or during the menstrual period. Headache tends to gradually improve after menopause. Pregnancy may improve, worsen, or have no effect on migraine.