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What causes migraines with high platelet count?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have had migraines for months, and I was put on medication, but it was not helping. Now I am on preventative and emergency medicines.

I have done an MRI, which showed abnormal results. Blood work showed platelets of 544. I was asked to consult a hematologist.

What can it be?

Kindly guide.

Thank you.

Hello,

Welcome to icliniq.com.

I have reviewed the reports of your MRI (magnetic resonance imaging) and blood (attachment removed to protect patient identity). They are incomplete reports, and I would like you to share the other sections of the reports as well for me to have a clear picture.

Well, the recurrent headaches most commonly diagnosed as a migraine can have other causes as well. One reason can be the excessive production of cells in your body, a condition known as polycythemia. The excessive cells produced in polycythemia lead to clogging of the blood vessels and decreased blood supply to the brain and other organs, leading to headaches, dizziness, etc.

From your MRI brain report, I see that they have mentioned marrow changes in your spine, and also the increased platelets lead to a suspicion of the following causes:

  1. Polycythemia vera.
  2. Essential thrombocytosis.
  3. Secondary polycythemia.

Another cause can be chronic myelogenous leukemia.

Now, to rule out all these causes, the following tests are required:

  1. Complete blood count.
  2. Peripheral smear.
  3. Bone marrow aspiration and biopsy, if needed, as decided by the hematologist.
  4. Presence of JAK2 mutation if needed to be decided by the hematologist.
  5. Serum erythropoietin levels.
  6. Leucocyte alkaline phosphatase levels.

Before proceeding with all these tests, I recommend you see a hematologist who would do a physical examination to check for various other signs of the conditions mentioned above. Based on that, a hematologist would advise you on the next plan of action.

Do not panic. All these conditions that I have mentioned can be treated.

I hope this helps.

Thank you.

Medically reviewed byDr. Vinodhini J.

Published At December 21, 2020
Reviewed AtJune 3, 2026

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