|The trigeminal nerve, shown in yellow, conducts signals from dilating blood vessels in the palate to the brain, which interprets the pain as coming from the forehead.|
|Classification and external resources|
A cold-stimulus headache, also known as brain freeze, ice-cream headache, trigeminal headache or its given scientific name sphenopalatine ganglioneuralgia (meaning "pain of the sphenopalatine ganglion"), is a form of brief pain or headache commonly associated with consumption (particularly quick consumption) of cold beverages or foods such as ice cream and ice pops. It is caused by having something cold touch the roof of the mouth, and is believed to result from a nerve response causing rapid constriction and swelling of blood vessels or a "referring" of pain from the roof of the mouth to the head. The rate of intake for cold foods has been studied as a contributing factor. A cold-stimulus headache is distinct from dentin hypersensitivity, a type of pain that can occur under similar circumstances.
The term ice-cream headache has been in use since at least January 31, 1937, contained in a journal entry by Rebecca Timbres published in the 1939 book We Didn't Ask Utopia: A Quaker Family in Soviet Russia.[non-primary source needed]
Cause and frequency
A cold-stimulus headache is the direct result of the rapid cooling and rewarming of the capillaries in the sinuses leading to periods of vasoconstriction and vasodilation. A similar but painless blood vessel response causes the face to appear "flushed" after being outside on a cold day. In both instances, the cold temperature causes the capillaries in the sinuses to constrict and then experience extreme rebound dilation as they warm up again.
In the palate, this dilation is sensed by nearby pain receptors, which then send signals back to the brain via the trigeminal nerve, one of the major nerves of the facial area. This nerve also senses facial pain, so as the neural signals are conducted the brain interprets the pain as coming from the forehead—the same "referred pain" phenomenon seen in heart attacks. Brain-freeze pain may last from a few seconds to a few minutes. Research suggests that the same vascular mechanism and nerve implicated in "brain freeze" cause the aura (sensory disturbance) and pulsatile (throbbing pain) phases of migraines.
It is possible to suffer from a cold-stimulus headache in both hot and cold weather, because the effect relies upon the temperature of the food being consumed rather than that of the environment. Other causes that may mimic the sensation of cold-stimulus headache include that produced when high speed drilling is performed through the inner table of the skull in people undergoing such a procedure in an awake or sedated state.
Anterior cerebral artery theory
Another theory into the cause of cold-stimulus headaches is explained by increased blood flow to the brain through the anterior cerebral artery, which supplies oxygenated blood to most medial portions of the frontal lobes and superior medial parietal lobes. This increase in blood volume and resulting increase in size in this artery is thought to bring on the pain associated with a cold-stimulus headache.
When the anterior cerebral artery constricts, reining in the response to this increased blood volume, the pain disappears. The dilation, then quick constriction, of this blood vessel may be a type of self-defense for the brain.
This inflow of blood cannot be cleared as quickly as it is coming in during the cold-stimulus headache, so the blood flow could raise the pressure inside the skull and induce pain that way. As the intracranial pressure and temperature in the brain rise the blood vessel contracts, and the pressure in the brain is reduced before reaching dangerous levels.
To relieve pain, some doctors suggest pressing the tongue against the roof of the mouth to warm the area, tilting the head back for 20 seconds, or drinking something warmer than whatever caused the headache. Some people report relief from breathing in through the mouth and out through the nose, thus passing warm air through the nasal passages. Others have noted that the Valsalva manoeuvre can speed the recovery of the headache, in spite of this contravening the Anterior Cerebral Artery Theory
The phenomenon is common enough to have been the subject of research published in the British Medical Journal and Scientific American. A study conducted by Maya Kaczorowski demonstrated a higher incidence of sphenopalatine ganglioneuralgia in subjects consuming the ice cream sample in less than 30 seconds vs. those who consumed slowly, with no time limit (27.3% and 12.5% respectively). However, Kaczorowski was ultimately not able to draw a clear connection between the speed of consumption and incidence of sphenopalatine ganglioneuralgia.
According to research by Nigel Bird, Anne MacGregor, and Marcia I. Wilkinson published in the journal Headache, in their study "17% of the migraine patients and 46% of the students developed headache following palatal application or a swallow of ice cream."
- Kaczorowski, Maya; Kaczorowski, Janusz (December 21, 2002). "Ice Cream Evoked Headaches (Ice-H) Study: Randomised Trial Of Accelerated Versus Cautious Ice Cream Eating Regiem". British Medical Journal. 325 (7378): 1445–1446. doi:10.1136/bmj.325.7378.1445. PMC 139031. PMID 12493658.
- Jankelowitz, SK.; Zagami, AS. (Dec 2001). "Cold-stimulus headache". Cephalalgia. 21 (10): 1002. doi:10.1046/j.1468-2982.2001.00301.x. PMID 11843876.
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- Timbres, Harry; Timbres, Rebecca (1939). "We didn't ask Utopia: a Quaker family in Soviet Russia". Prentice Hall. Retrieved 2013-02-19.
But your nose and fingertips get quite numb, though, and if you don't keep rubbing your forehead, you get what we used to call 'an ice cream headache.'
- Scientific American Mind, 1555–2284, 2008, Vol. 19, Issue 1. "Brain Freeze." Andrews, Mark A., Lake Erie College of Osteopathic Medicine.
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