Brief Answer:
Possible migraine headache upon awakening best seen in ER now

Detailed Answer:
Good evening and thank you for your question.

As a neurologist who is 1200 miles from where you are complaining of what is possibly a MIGRAINE HEADACHE with elevated blood pressure who also complains of DIZZINESS, as well as nausea and recently had what sounds to have been a carotid endarterectomy my concern is that you could be exhibiting symptoms of a potential stroke to the posterior fossa of the brain (cerebellum).

Sometimes headaches and dizziness are the only manifestations of this type of stroke. Of course, along with dizziness (which itself is slightly vague since I do not know if you are talking about being lightheaded or do you feel like you or the world are spinning as in VERTIGO?) comes difficulty walking and maintaining balance. This automatically makes me think in terms of either a cerebellar stroke or bleed and therefore, as a PASSIVE OBSERVER from 1200 miles away I would counsel you to visit your local ER if these symptoms are new in onset and entirely different from anything you've ever had before.

I would also counsel you to stop taking any aspirin, plavix, aggrenox, or any other medication that you were told after the carotid surgery as a blood thinner. If you were already on something such as WARFARIN or COUMADIN for another condition such pulmonary embolus, atrial fibrillation, or blood clot in the legs then, I would NOT stop that medication but everything of a blood thinning nature I would stop until seen and cleared by the ER doctors.

You should put a call in as well to your primary doctor as well as the doctor who performed the carotid artery procedure and let them know of this development. They may be able to facilitate your being triaged through the ER so that you don't have to wait in the waiting room. The risk is that if this is a STROKE IN EVOLUTION and you've already waited at least a couple of hours that things may to get worse and there could more serious complications if a diagnosis is not quickly made by getting at least a rapid CT scan of the head and performing a neurological examination on you.

If this turns out just to be a migraine headache and nothing else is going on then, at least you know exactly what it is and can deal with that using prescription medication until you see your regular doctor.

But under the circumstances young lady....my best advice is that you be seen as soon as possible at the local ER for further workup and intervention as needed.

If I've provided useful or helpful information to your question and you have no further inquiries or comments at this time then, could you do me the utmost of favors in CLOSING THE QUERY along with a few POSITIVE WORDS of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few days or weeks if you'd drop me a line at www.bit.ly/drdariushsaghafi

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you get a little more direction as to what you may wish to do as well as discuss with your doctors in order to help get you feeling back to normal as soon as possible.

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