Migraine headaches are recurrent moderate to severe headaches, typically unilateral in location, pounding or pulsating in quality of pain, and lasting 4-72 hours. Nausea and/or vomiting, photophobia, and/or phonophobia may accompany the headaches. Symptoms are usually worse with activity. Headaches may or may not be preceded by an aura, which is a transient visual, language, sensory, or motor disturbance. The International Classification of Headache Disorders, 3rd edition (ICHD-3), identifies 3 main categories: migraine without aura, migraine with aura, and chronic migraine. 

Patients may identify triggers that induce headaches. For some women, hormonal changes (particularly fluctuations in estrogen levels) can serve as a significant trigger, potentially leading to menstrual migraines. There may also be a positive family history of migraine headache. Age of onset varies, and migraine headaches can start in childhood, although they most commonly begin between the ages of 15 and 25, with onset in girls often starting around menarche. Migraines are 3 times more common in women than in men.

Variants:

• A small percentage of patients may experience migraine attacks without any associated head pain, typically characterized by migrainous aura and/or other migrainous symptoms such as photophobia or nausea. Migraine aura without headache is also known as a "silent migraine."
• Hemiplegic migraine is a rare variant of migraine with aura that presents with episodic and reversible attacks of headache and unilateral motor weakness.
• A migraine with brain stem aura, also known as a basilar migraine headache, is a type of migraine with aura symptoms that originate from the brain stem or bilateral cerebral hemispheres.
• Retinal migraine, which presents with visual symptoms in one eye, can occur with or without associated headache.