HEALTH: Snowball headaches, what they are and ways to get rid of them

Sometimes when I bite directly into a snowball, I get this intense stabbing pain. It feels as though all my brain material and juices freeze,” says Kara Mihlon, a junior studying civil engineering at LSU in Baton Rouge.
“The pain starts in my forehead and quickly moves past my ears to the back of the head. I hold the snowball in one hand and press the other to my forehead, applying as much pressure as possible. It usually lasts only a few seconds … thank goodness.”
HEALTH: Snowball headaches, what they are and ways to get rid of themOther sufferers describe various heralding symptoms beginning in the back of the throat, down in the esophagus, behind an eye, or a toothache immediately prior to the onset of the head pain.
These crescendo, but fleeting, attacks of cold-induced pain go by several monikers – ice cream headache, brain freeze, frozen brain syndrome and freezer head. Current medical terminology is a cold stimulus headache.
In the rest of the world, this intense cold-induced pain phenomenon is a summertime experience of children gulping ice cream or adults bending back with frozen margaritas and daiquiris. Our New Orleans outbreak begins in May, peaks in June and July, and fades out in September like clockwork with the opening and closing of snowball stands across the metropolitan area.
A local moniker for the cold stimulus headache is a “snowball headache,” a term I first heard used by food writer and radio host Tom Fitzmorris.
At least one person in three says eating really cold foods can induce one of these brief episodes of discomfort. The sensation normally lasts 10 to 20 seconds but can persist for up to a minute. A post-headache throbbing for up to five minutes often follows the acute attack.
It is unclear why some folks get these intense pains and others never do. It is difficult to find anyone locally who claims immunity. One study on the phenomenon suggested that a person with a history of migraine headaches was more likely to experience brain freeze. As often the case in science, this claim was not supported by better planed, follow-up surveys.
“I get a brain freeze every time I eat a Hansen snowball. Pineapple flavor causes the most intense,” says Chris Kirsch, 38, a Hansen snowball historian. “If you eat too much too quickly, it always creates a mini-headache.”
Indeed, there is a scientific basis to explain why Kirsch has identified pineapple as a potent inducer of these headaches. It is higher in fat content than many of the other flavors, and dairy science research shows products with higher fat content melt slower. This preserves and intensifies the cold stimulus.
To date, this is one potential product liability problem which has not attracted any lawsuits.
“No lawsuits and nobody gets mad. The only sour faces we see around here are when someone is eating lemonade. We have a very patient crowd trained by my grandparents. They wait in line,” says Ashley Hansen with a tear in her eye.
Her grandfather Ernest died in March. Her grandmother Mary died just after Hurricane Katrina. Ernest Hansen Sr. invented the Sno-Bliz machine, the device that saved New Orleans from the wet cracked ice snowballs plaguing the rest of the world and giving snowballs a bad name in culinary circles.
The mantle has passed. Ashley Hansen now operates the Hansen’s Sno-Blitz Shop at 4801 Tchoupitoulas Street (891-9788). No Chinese takeout paper boxes or Styrofoam cups of cracked wet ice with diluted flavors here. Only pure, fluffy shaved snow, carefully packed in a Hansen traditional plastic cup and blessed with multiple pourings of their classic flavors.
These potently cold Hansen “stomach air-conditioners” stimulate peculiar sensations in addition to transient headaches and loyal customers.
“I get a back pain when I eat one. It is a brief, sharp pain I feel directly in my back,” says longtime Hansen snowball devotee Beth Ryan, pointing to her thoracic spine just below her shoulder blades.
“Ice cream will do it sometimes, but mostly just Hansen snowballs. Please don’t quote me. I have never told anybody about this before,” adds the world’s now first-reported sufferer of “Hansen snowball backache.”
Dr. Joseph Hulihan, a Philadelphia neurologist, wrote a definitive medical review in 1997 ( He discussed possible theories on how a cold stimulus causes these intense but short-lived episodes of cephalic pain.
He describes the work of an earlier researcher who experimented on himself by applying crushed ice to various places from his mouth to his stomach. Ice on only one side of the rear roof of his mouth caused a headache occurring on that side of his head in the temple and eye regions. When the cold stimulus was applied to the middle of the roof of his mouth, the sharp fleeting pain occurred bilaterally. Ice applications in the esophagus and stomach did not reproduce the pain sensation.
Earlier researchers postulated that the cold stimulus headache was a neuronal manifestation of referred pain, a nerve pathway angry to be chilled. Others tout a physiological etiology based on constriction of blood vessels.
For sure, intense cold chills the soft palate at the back of the throat. This rapid cooling seems to cause sensitive small blood vessels in the brain to dilate regardless of whether the pathway is neuronal or vascular. Of note, the mechanism may be akin to migraine in which a trigger of some sort causes expansion of a blood vessel in the brain.
The etiologic puzzle may not be solved, but Tom Fitzmorris has the general idea: “You cool off a couple of bulbs in the back of your nose if you eat a snowball too fast.”
Since ice cream and snowball abstinence is not an option for most, treatment and preventive recommendations for cold stimulus headache abound. The British Medical Journal generated a flurry of treatment suggestions from around the world, which they still receive and post (see box).
The regulars at Hansen’s still quote the master.
“Old man Hansen told me how to stop it. Press your tongue as hard as you can to the roof of your mouth to warm it up,” volunteers Kirsch.
“He told you that?” queries Hansen referring to her grandfather. “I never heard that. I watch facial expressions when I hand a snowball to a customer. If I see that pained look, I tell them to warm the roof of their mouth with their thumb.”
“I never used my thumb,” says Kirsch. “Sticking my thumb in my mouth would make me look like an idiot.”

Cures for cold stimulus headaches – the victims speak
• “Don’t eat anything cold too quickly.”
• “Warm your throat with your hand; the pain goes away almost instantly.”
• “I blow warm air out of my nose. I don’t know what this does, but it works.”
• “You can stop an ice cream headache by placing a cold object on the inner wrist and holding it there. The headache stops really fast.”
• “Upon the first spike of pain, quickly lean forward at the waist until your head is below the plane of your heart. The sudden rush of blood to the neck and head creates a surge in temperature sufficient to overcome the effects of the cold within seconds.”
• “Yup! I occasionally get a brain freeze, but more often I experience chest pain especially when drinking a frozen drink such as a margarita – an esophagus freeze. A drink of room temperature to cool water tends to cure it, but it is definitely unpleasant while it lasts!”
• “I really don’t understand why people want to get rid of the ‘brain freeze’ so fast. The longest one I have had lasted only 10-15 seconds, and quite honestly I like them.”
Source: Edited Rapid Responses as posted on the British Medical Journal website

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