Brief Answer:

Short duration sharp/sudden onset explosive headache

Detailed Answer:

Hello,

The first would be a TRIGEMINAL AUTONOMIC CEPHALGIC form of headache (TAC). There are a couple of different types of these rather painful entities that can produce the types of symptoms you've described.

One is called JABS AND JOLTS headache. These are sudden brief SEVERE HEAD pains that stab people over certain parts of the head and then, completely go away.

They can recur in the same day, at times uncountable numbers of times. In your case apparently, it was only twice. Typically, it can happen up to 10x a day or more if the duration of the JOLTS is 2-3 seconds each.

Yours, however, are more like 2 minutes or at least minutes long. Therefore, JABS AND JOLTS would be less likely based on timing.

The next one I would think of would be PAROXYSMAL HEMICRANIA. This form of TAC affects exactly HALF of the head and the duration of these sudden, OUT OF THE BLUE, very painful headaches is 2-30 minutes.

Then, they go away as quickly as they come on. This sounds like the description you gave and it repeated itself on the opposite side.

A 3rd type of headache that could fit this picture by description has the generic name of LONE ACUTE SEVERE HEADACHE or LASH. A more recognized term among doctors would be the THUNDERCLAP HEADACHE.

This headache comes on without warning and its pain intensity peaks from seconds to about 1-2 minutes at most. It is very disabling and can cause people to shreak out in pain. It goes away as quickly as it came on and people are extremely drained after one of those episodes.

The cause of this headache used to be almost exclusively attributed to either a ruptured aneurysm within the brain or a bit of bleeding from an aneurysm which hasn't yet burst. Therefore, many people consider this type of headache PREMONITORY or predictive of a more serious condition.

However, it is now known that other causes for THUNDERCLAP HEADACHE exist which do not necessarily cause such dramatic or potentially bad consequences.

For example, heavy physical exertional activities, hyperacute rise in intracranial CSF or BLOOD pressure, lack of oxygen to the brain causing a stroke, inflammation of the brain or arteries feeding the brain, and there are other causes.

I doubt your episodes had much to do with your previous of Bell's palsy.

I agree with your concern at these episodes today and for that reason my recommendation is that you submit to a local neurologist for a good thorough checkup as well as imaging studies to include an MRI of the brain as well as an MRA of the head and neck.

I would also use a XXXXXXX substance called GADOLINIUM. First, you should have your kidneys checked for their integrity but getting a CREATININE and EGFR (CALCULATED) performed in blood.

If the EGFR is at least 50-60 then, it is safe to give the patient the XXXXXXX If < those values then, extreme care should be taken in administering that contrast substance.

I would get these things rolling first thing in the morning and put everything else on hold right now until this is resolved and you know what the status of the inside of your skull looks like. I would be happy to even review any reports or films if you can get them in hand.

I cannot suggest a treatment until we have confirmation as to what the diagnosis may be inside the head.

Hope I have answered your query.

Take care

Regards,
Dr Dariush Saghafi, Neurologist

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