View source for Cold-stimulus headache

{{Redirect|Brain freeze||Brain freeze (disambiguation)}}
{{Infobox medical condition (new)
| name          = Cold-stimulus headache
| synonyms      = Ice-cream headache, brain freeze<ref name="ICE-H">{{cite journal |last1=Kaczorowski |first1=Maya |last2=Kaczorowski |first2=Janusz |date=December 21, 2002 |title=Ice cream evoked headaches (ICE-H) study: randomised trial of accelerated versus cautious ice cream eating regimen |journal=British Medical Journal |doi=10.1136/bmj.325.7378.1445 |pmid=12493658 |volume=325 |issue=7378 |pages=1445–1446 |pmc=139031}}</ref><ref>{{cite journal |last1=Jankelowitz |first1=SK. |last2=Zagami |first2=AS. |date=Dec 2001 |title=Cold-stimulus headache. |journal=Cephalalgia |doi=10.1046/j.1468-2982.2001.00301.x |pmid=11843876 |volume=21 |issue=10 |page=1002|s2cid=28861589 |doi-access=free }}</ref>
| image         = Girl with Ice Cream - Southend-on-Sea - Essex - England (27713936233).jpg
| caption       = A young girl hastily consuming [[ice cream]], a common cause of cold-stimulus headaches, which are aptly called "brain freezes" or "ice-cream headaches"
| pronounce     = 
| field         = [[Neurology]]
| symptoms      = 
| complications = 
| onset         = 
| duration      = 20 seconds to 2 minutes depending on severity
| types         = 
| causes        = Quick consumption of cold foods and beverages or prolonged oral exposure to cold stimuli
| risks         = 
| diagnosis     = 
| differential  = 
| prevention    = 
| treatment     = Removal of the cold stimulus from the oral cavity and thrusting the tongue towards the tip of the nose or roof of the mouth to relieve pain. Drinking warm water can also ease pain.
| medication    = 
| prognosis     = 
| frequency     = 
| deaths        = 
| alt           = 
}}
A '''cold-stimulus headache''', colloquially known as an '''ice-cream headache''' or '''brain freeze''', is a form of brief pain or [[headache]] commonly associated with consumption (particularly quick consumption) of cold [[drink|beverage]]s or foods such as [[ice cream]], [[ice pop|popsicle]]s, and [[snow cone]]s. It is caused by a cold substance touching the [[palate|roof of the mouth]], and is believed to result from a nerve response causing rapid constriction and swelling of blood vessels,<ref>{{cite web|url=http://science.howstuffworks.com/question96.htm|title=What causes an ice cream headache?|date=1 April 2000}}</ref> "[[Referred pain|referring]]" pain from the roof of the mouth to the head.<ref>{{cite web|url=http://www.mayoclinic.com/health/ice-cream-headaches/DS00640/DSECTION=causes|title=Ice cream headaches Causes{{dash}}Mayo Clinic}}</ref><ref>{{cite web|url=http://www.medterms.com/script/main/art.asp?articlekey=34149|title=Definition of Ice cream headache|access-date=2009-03-25|archive-date=2014-09-24|archive-url=https://web.archive.org/web/20140924041044/http://www.medterms.com/script/main/art.asp?articlekey=34149|url-status=dead}}</ref> The rate of intake for cold foods has been studied as a contributing factor.<ref name="ICE-H" /><ref>{{cite web|url=http://www.foodsci.uoguelph.ca/dairyedu/icheadache.html|title=The Dairy Education eBook Series{{dash}}Food Science|website=[[University of Guelph]]}}</ref> It can also occur during a sudden exposure of the unprotected head to cold temperatures, such as by diving into cold water.<ref>{{Cite web |title=Ice cream headaches{{dash}}Symptoms and causes |url=https://www.mayoclinic.org/diseases-conditions/ice-cream-headaches/symptoms-causes/syc-20373733 |access-date=2022-03-22 |website=Mayo Clinic |language=en}}</ref> A cold-stimulus headache is distinct from [[dentin hypersensitivity]], a type of dental pain that can occur under similar circumstances.

[[Cats]] and other animals have been observed exhibiting a similar reaction when presented with a similar stimulus.<ref>{{cite web|url=http://www.petmd.com/news/cat/do-cats-get-brain-freezes-when-they-eat-cold-treats-34364|title=Do Cats Actually Get 'Brain Freeze' When They Eat Cold Treats?{{dash}}petMD|website=www.petmd.com}}</ref>

==History==
According to ''[[The New Yorker]]'', the first written account of a cold-stimulus headache comes from [[Patrick Brydone]] in the 1770s. Brydone described a British naval officer in Sicily who consumed a large bite of [[ice cream]] and spat it out "with a horrid oath".<ref>{{Cite magazine |last=Twilley |first=Nicola |date=June 8, 2024 |title=How the Fridge Changed Flavor |url=https://www.newyorker.com/culture/the-weekend-essay/how-the-fridge-changed-flavor |url-status=live |archive-url=https://web.archive.org/web/20240609102911/https://www.newyorker.com/culture/the-weekend-essay/how-the-fridge-changed-flavor |archive-date=June 9, 2024 |access-date=June 9, 2024 |magazine=[[The New Yorker]]}}</ref>

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''.<ref name="utopia">{{cite web |last1=Timbres |first1=Harry |last2=Timbres |first2=Rebecca |date=1939 |title=We didn't ask Utopia: a Quaker family in Soviet Russia |publisher=[[Prentice Hall]] |url=https://archive.org/stream/wedidntaskutopia00timbrich#page/224/mode/2up/search/ice+cream |access-date=2013-02-19 |quote=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.'}}</ref>{{primary inline|date=November 2017}} The first published use of the term ''brain freeze'', in the sense of a cold-stimulus headache, was in 1986.<ref name="oed-etymology">{{Cite OED|term=brain freeze}}</ref>{{efn|The earliest recorded use of the term "brain freeze" (with a different meaning) was in 1968 in a Canadian academic journal.<ref name="oed-etymology" />}} [[7-Eleven|7-{{zwj}}Eleven]] has [[trademark]]ed the term.<ref>{{Cite web|title=BRAINFREEZE{{dash}}Trademark Details|url=http://trademarks.justia.com/868/37/brainfreeze-86837996.html|url-status=live|archive-url=https://web.archive.org/web/20200606074230/https://trademarks.justia.com/868/37/brainfreeze-86837996.html|archive-date=2020-06-06|access-date=2020-06-06|website=Justia Trademarks|language=en}}</ref>

==Cause and frequency==
A cold-stimulus headache is thought to be 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 low temperature causes the capillaries in the sinuses to constrict and then experience extreme rebound dilation as they warm up again.<ref name="sa">''Scientific American Mind'', 1555–2284, 2008, Vol. 19, Issue 1. ''"Brain Freeze."'' Andrews, Mark A., Lake Erie College of Osteopathic Medicine.</ref>

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 [[migraine]]s.<ref name="bmj">{{cite journal |last=Hulihan |first=Joseph |date=1997 |title=Ice cream headache |journal=BMJ |doi=10.1136/bmj.314.7091.1364 |volume=314 |issue=7091 |page=1364|pmid=9161304 |pmc=2126629 }}</ref>

It is possible to have a cold-stimulus headache in both hot and cold weather, contrary to [[List of common misconceptions|popular belief]], because the effect relies upon the temperature of the food being consumed rather than that of the environment.<ref>{{Cite news |last=O’Connor |first=Anahad |date=October 11, 2010 |title=The Claim: 'Brain Freeze' Occurs Only on Warm Days |url=https://www.nytimes.com/2010/10/12/health/12really.html |access-date=June 24, 2024 |work=[[The New York Times]]}}</ref><ref>{{Cite journal |last1=Kaczorowski |first1=Maya |last2=Kaczorowski |first2=Janusz |date=December 21, 2002 |title=Ice cream evoked headaches (ICE-H) study: randomised trial of accelerated versus cautious ice cream eating regimen |journal=[[The BMJ]] |volume=325 |issue=7378 |pages=1445–1446 |doi=10.1136/bmj.325.7378.1445 |pmid=12493658 |pmc=139031 }}</ref> 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.
[[File:Gray778 Trigeminal.png|thumb|218x218px|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.{{citation needed|date=August 2021}}]]

===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 lobe]]s 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.{{citation needed|date=August 2021}}

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.{{citation needed|date=August 2021}}

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.<ref>{{cite web |last=Welsh |first=Jennifer |date=22 April 2012 |title=Cause of Brain Freeze Revealed |publisher=TechMediaNetwork.com |url=http://www.livescience.com/19834-brain-freeze-blood-flow-migraines.html |access-date=2012-04-24}}</ref>

==Research==
Due to how shortlived the headache is, researchers like Amokrane Chebini and Esma Dilli have voiced how difficult it is to study the phenomenon.<ref>{{cite journal |last1=Chebini |first1=Amokrane |last2=Dilli |first2=Esma |title=Cold Stimulus Headache |journal=Curr Neurol Neurosci Rep |date=June 2019 |volume=19 |issue=46 |page=46 |doi=10.1007/s11910-019-0956-5 |pmid=31172287 |url=https://rdcu.be/d06bs |access-date=22 November 2024|url-access=subscription }}</ref> Thus, there is not much research that has been conducted on the topic.

The phenomenon is common enough to have been the subject of research published in the ''[[British Medical Journal]]'' and ''[[Scientific American]]''.<ref name="sa"/><ref name="bmj"/> A study conducted by Maya Kaczorowski demonstrated a higher incidence of headache in subjects consuming an ice cream sample quickly, in less than five seconds, vs. those who consumed slowly, taking longer than thirty seconds (27% and 12%, respectively).<ref name="ICE-H" />

According to research conducted by Nigel Bird, [[Anne MacGregor]], and Marcia I. Wilkinson published in the journal ''[[Headache (journal)|Headache]]'', "17% of the migraine patients and 46% of the students developed headache following palatal application or a swallow of ice cream."<ref name="Bird92">{{cite journal |last1=Bird |first1=Nigel |last2=MacGregor |first2=Anne |last3=Wilkinson |first3=Marcia I. |year=1992 |title=Ice cream headache–site, duration, and relationship to migraine |journal=[[Headache (journal)|Headache]] |volume=32 |issue=1 |pages=35–8 |publisher=[[Wiley-Blackwell]] |doi= 10.1111/j.1526-4610.1992.hed3201035.x|pmid=1555929|s2cid=45688979 }}</ref>

According to research conducted by Ilaria Bonemazzi and several other colleagues found that the children participants in their study were more likely to develop cold-stimulus headaches compared to their adult counterparts.<ref>{{cite journal |last1=Bonemazzi |first1=Ilaria |last2=Pelizza |first2=Maria Federica |last3=Berti |first3=Giulia |last4=Ancona |first4=Claudio |last5=Nosadini |first5=Margherita |last6=Sartori |first6=Stefano |last7=Toldo |first7=Irene |title=Cold-Stimulus Headache in Children and Adolescents |journal=Life |date=April 2023 |volume=13 |issue=4 |page=973 |doi=10.3390/life13040973 |doi-access=free |pmid=37109502 |pmc=10144624 }}</ref> This may suggest that children are more sensitive to cold-stimulus headaches, and that children grow a resistance to these headaches as they grow into adults.

Cold-stimulus headaches are not always caused by consuming ice cream and other cold foods similar to it; it has been found that simply being in a colder environment may trigger the same symptoms associated with a cold-stimulus headache. In a letter written by SK Jankelowitz and AS Zagami, the authors describe a patient who experienced cold-stimulus headache symptoms while she was ice skating. <ref>{{cite journal |last1=Jankelowitz |first1=SK. |last2=Zagami |first2=AS. |date=Dec 2001 |title=Cold-stimulus headache. |journal=Cephalalgia |doi=10.1046/j.1468-2982.2001.00301.x |pmid=11843876 |volume=21 |issue=10 |page=1002|s2cid=28861589 |doi-access=free }}</ref>

In research conducted by Anthony Khoo, Michelle Kiley, and Peter J Goadsby, it was found that naproxen was seen to prevent the symptoms of a cold-stimulus headache when it was taken thirty minutes before the exposure and ingestion of a cold substance. <ref>{{cite journal |last1=Khoo |first1=Anthony |last2=Kiley |first2=Michelle |last3=Goadsby |first3=Peter J |title=Managing external cold-stimulus headache with preventive naproxen |journal=Cephalalgia Reports |date=April 2020 |volume=3 |issue=4 |doi=10.1177/2515816320915696 |doi-access=free }}</ref>

==Notes==
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==References==
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{{Headache}}
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|  ICD10          = G44.8021 (ICD-10NA)
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[[Category:Headaches]]