A cold-stimulus headache, colloquially known as an ice-cream headache or brain freeze, is a form of brief pain or

headache A headache, also known as cephalalgia, is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of Depression (mood), depression in those with severe ...

commonly associated with consumption (particularly quick consumption) of cold

beverage A drink or beverage is a liquid intended for human consumption. In addition to their basic function of satisfying thirst, drinks play important roles in human culture. Common types of drinks include plain drinking water, milk, juice, smoothie ...

s or foods such as

ice cream Ice cream is a frozen dessert typically made from milk or cream that has been flavoured with a sweetener, either sugar or an alternative, and a spice, such as Chocolate, cocoa or vanilla, or with fruit, such as strawberries or peaches. Food ...

, popsicles, and

snow cone A snow cone (or snow kone, sno kone, sno-kone, sno cone, or sno-cone) is a ground-up ice dessert commonly served in paper cones or foam cups. This is not to be confused with shaved ice which shaves a thin layer of ice off an ice block instea ...

s. It is caused by a cold substance touching the roof of the mouth, and is believed to result from a nerve response causing rapid constriction and swelling of blood vessels, " referring" pain from the roof of the mouth to the head. The rate of intake for cold foods has been studied as a contributing factor. It can also occur during a sudden exposure of the unprotected head to cold temperatures, such as by diving into cold water. A cold-stimulus headache is distinct from

dentin hypersensitivity Dentin hypersensitivity (DH, DHS) is dental pain which is sharp in character and of short duration, arising from exposed dentin surfaces in response to stimuli, typically thermal, evaporative, tactile, osmosis, osmotic, chemical or electrical; an ...

, a type of dental pain that can occur under similar circumstances.

Cats The cat (''Felis catus''), also referred to as the domestic cat or house cat, is a small domesticated carnivorous mammal. It is the only domesticated species of the family Felidae. Advances in archaeology and genetics have shown that the ...

and other animals have been observed exhibiting a similar reaction when presented with a similar stimulus.

History

According to ''

The New Yorker ''The New Yorker'' is an American magazine featuring journalism, commentary, criticism, essays, fiction, satire, cartoons, and poetry. It was founded on February 21, 1925, by Harold Ross and his wife Jane Grant, a reporter for ''The New York T ...

'', 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

and spat it out "with a horrid oath". 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''. The first published use of the term ''brain freeze'', in the sense of a cold-stimulus headache, was in 1986.

7-Eleven 7-Eleven, Inc. is an American convenience store chain, headquartered in Irving, Texas. It is a wholly owned subsidiary of Seven-Eleven Japan, which in turn is owned by the retail holdings company Seven & I Holdings. The chain was founde ...

has

trademark A trademark (also written trade mark or trade-mark) is a form of intellectual property that consists of a word, phrase, symbol, design, or a combination that identifies a Good (economics and accounting), product or Service (economics), service f ...

ed the term.

Cause and frequency

A cold-stimulus headache is thought to be the direct result of the rapid cooling and rewarming of the

capillaries A capillary is a small blood vessel, from 5 to 10 micrometres in diameter, and is part of the microcirculation system. Capillaries are microvessels and the smallest blood vessels in the body. They are composed of only the tunica intima (the in ...

in the

sinuses Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity. The maxillary sinuses are located under the eyes; the frontal sinuses are above the eyes; the ethmoidal sinuses are between the eyes and the sphenoi ...

leading to periods of

vasoconstriction Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, in particular the large arteries and small arterioles. The process is the opposite of vasodilation, the widening of blood vesse ...

and

vasodilation Vasodilation, also known as vasorelaxation, is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. Blood vessel wa ...

. A similar, but painless,

blood vessel Blood vessels are the tubular structures of a circulatory system that transport blood throughout many Animal, animals’ bodies. Blood vessels transport blood cells, nutrients, and oxygen to most of the Tissue (biology), tissues of a Body (bi ...

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.''Scientific American Mind'', 1555–2284, 2008, Vol. 19, Issue 1. ''"Brain Freeze."'' Andrews, Mark A., Lake Erie College of Osteopathic Medicine. In the palate, this dilation is sensed by nearby pain receptors, which then send signals back to the

brain The brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It consists of nervous tissue and is typically located in the head (cephalization), usually near organs for ...

via the

trigeminal nerve In neuroanatomy, the trigeminal nerve (literal translation, lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for Sense, sensation in the face and motor functions ...

, 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 Referred pain, also called reflective pain, is pain perceived at a location other than the site of the painful stimulus. An example is the case of angina pectoris brought on by a myocardial infarction (heart attack), where pain is often felt in t ...

" 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 Migraine (, ) is a complex neurological disorder characterized by episodes of moderate-to-severe headache, most often unilateral and generally associated with nausea, and light and sound sensitivity. Other characterizing symptoms may includ ...

s. It is possible to have a cold-stimulus headache in both hot and cold weather, contrary to popular belief, because the effect relies upon the temperature of the food being consumed rather than that of the environment. 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. Gray778 Trigeminal

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 The anterior cerebral artery (ACA) is one of a pair of cerebral arteries that supplies oxygenated blood to most midline portions of the frontal lobes and superior medial parietal lobes of the brain. The two anterior cerebral arteries arise from th ...

, which supplies oxygenated blood to most medial portions of the

frontal lobe The frontal lobe is the largest of the four major lobes of the brain in mammals, and is located at the front of each cerebral hemisphere (in front of the parietal lobe and the temporal lobe). It is parted from the parietal lobe by a Sulcus (neur ...

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. 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. 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 Intracranial pressure (ICP) is the pressure exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue. ICP is measured in millimeters of mercury ( mmHg) and at rest, is normally 7–15 mmHg for a supine adu ...

and temperature in the brain rise the blood vessel contracts, and the pressure in the brain is reduced before reaching dangerous levels.

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. 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 ''The BMJ'' is a fortnightly peer-reviewed medical journal, published by BMJ Publishing Group Ltd, which in turn is wholly-owned by the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world ...

'' and ''

Scientific American ''Scientific American'', informally abbreviated ''SciAm'' or sometimes ''SA'', is an American popular science magazine. Many scientists, including Albert Einstein and Nikola Tesla, have contributed articles to it, with more than 150 Nobel Pri ...

''. 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). According to research conducted by Nigel Bird, Anne MacGregor, and Marcia I. Wilkinson published in the journal ''

Headache A headache, also known as cephalalgia, is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of Depression (mood), depression in those with severe ...

'', "17% of the migraine patients and 46% of the students developed headache following palatal application or a swallow of ice cream." 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. 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. 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.

Notes

References

{{Medical resources , DiseasesDB = , ICD10 = G44.8021 (ICD-10NA) , ICD9 = , ICDO = , OMIM = , MedlinePlus = , eMedicineSubj = , eMedicineTopic = , MeshID = Headaches