Migraines are linked to a phenomenon called cortical spreading depression, a wave of electrical activity in the brain. This wave is believed to be responsible for the migraine aura, those strange visual or sensory disturbances some people experience before the headache begins. As it spreads, it triggers the release of chemicals that activate the pain pathways in the brain, leading to the throbbing headache.

The trigeminovascular system plays a key role in migraines, involving a network of nerves that innervate the blood vessels in the brain. Activation of these nerves leads to the release of substances such as substance P and CGRP, promoting inflammation and pain. This system explains why migraines often cause pain in the head and neck areas.

Genetics can significantly influence an individual's susceptibility to migraines. Studies show that migraines tend to run in families, indicating a hereditary component. Specific genes related to nerve excitability and pain pathways have been identified, although the exact mechanisms remain unclear. Understanding these genetic factors could aid in developing targeted treatments.

Understanding the causes of migraines can lead to better management strategies.