Welcome to The Pearl Log — where post-shift wisdom surfaces, one shiny clinical take at a time. Some pearls are fresh, some are rough, all are found under pressure.
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Migraine Headache Pathophys + Diagnosis
Migraine is a primary disorder of neuronal dysfunction, driven by abnormal brain excitability and dysregulated pain modulation. Cortical spreading depression and trigeminovascular activation lead to CGRP-mediated neurogenic inflammation and progressive sensitization, leading to aura, headache pain, and associated symptoms. This modern framework clarifies why migraine presents in predictable phases and why early, mechanism-targeted treatment in the ED matters.