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I Have Been Having Nearly Daily Headaches For Four Months.
Question: I have been having nearly daily headaches for four months. It is not a sinus headache as my breathing is fine. I would say its the top of my head more towards the front. It hurts to sneeze, sometimes it hurts to cough, when I am in the gym and my head is a lower elevation than my feet and attempt to lift a weight the pressure in my head is unbearable and I cannot perform the exercise. The pressure relieves when I stop and get upright. I do not have high blood pressure. I had a brain MRI which came back normal. I saw a neurologist who prescribed beta blockers which I did not take due to the side effect risk. No one has been able to tell me what is wrong.
Brief Answer:
Most likely migraine, however raised ICP needs to be excluded.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.
I have noted your clinical details. Based on this, the most likely diagnosis is migraine. Migraine headaches can worsen with exertion and physical activity. For severe attacks of headache, you can take rizatriptan or naproxen tablets. In order to reduce the headaches in future, you can take propranolol or topiramate tablets. Side effects are uncommon and mild in nature.
In view of symptoms such as increase in headache severity on sneezing and coughing, we need to exclude raised intracranial pressure (ICP). For this, fundus examination by an ophthalmologist would help. If fundus does not show papilledema, then, raised ICP is unlikely.
You should also avoid the headache triggers such as exposure to sunlight, loud noise or pollution. You should eat on time and sleep well. Avoid stress and tension.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Most likely migraine, however raised ICP needs to be excluded.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.
I have noted your clinical details. Based on this, the most likely diagnosis is migraine. Migraine headaches can worsen with exertion and physical activity. For severe attacks of headache, you can take rizatriptan or naproxen tablets. In order to reduce the headaches in future, you can take propranolol or topiramate tablets. Side effects are uncommon and mild in nature.
In view of symptoms such as increase in headache severity on sneezing and coughing, we need to exclude raised intracranial pressure (ICP). For this, fundus examination by an ophthalmologist would help. If fundus does not show papilledema, then, raised ICP is unlikely.
You should also avoid the headache triggers such as exposure to sunlight, loud noise or pollution. You should eat on time and sleep well. Avoid stress and tension.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Raju A.T
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