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Suggest Remedies For Chronic Headache
Question: My wife has a chronic headache nearly every day for the past 14 months or so. The symptoms are mostly pain to the right side and pressure near the top of her head. It can only be relieved when she lies down with an ice pack applied to her head. However, after she rises and starts moving around, these symptoms return within thirty minutes or so. She has been diagnosed as likely having a spinal fluid leak but the leak could not be found after two blood patches and a third "glue" patch. Now she is scheduled to have a POTS test but her symptoms don't really match the typical POTS patient. Do you have any suggestions or know of any specialist that has had patients with this condition? Desperate. Thank you.
Brief Answer:
Upper cervical instability and intracranial hypotension to consider.
Detailed Answer:
Hello and thanks for using HCealthcareMagic.
I have read your question and understand your concerns.
POTS is very unlikely if there is notable tachycardia, and this type of headaches is not typical of POTS.
In my opinion, intracranial hypotension should be considered and investigated further.
If there is suspected a fluid leak, a brain MRI and a dynamic myelography with fluoroscopy are necessary to confirm or exclude this diagnosis.
The situation could be less complicated if there is upper cervical spine instability that may contribute to compression of upper cervical nerves when upright.
Dynamic X-rays of the cervical spine and MRI are necessary to assess correctly this possibility.
Discuss with your wife's Doctor about getting evaluated further.
Consultations with a spine specialist and a Neurologist are necessary.
Hope you found the answer helpful. Please let me know if I can assist you further.
Take care.
Upper cervical instability and intracranial hypotension to consider.
Detailed Answer:
Hello and thanks for using HCealthcareMagic.
I have read your question and understand your concerns.
POTS is very unlikely if there is notable tachycardia, and this type of headaches is not typical of POTS.
In my opinion, intracranial hypotension should be considered and investigated further.
If there is suspected a fluid leak, a brain MRI and a dynamic myelography with fluoroscopy are necessary to confirm or exclude this diagnosis.
The situation could be less complicated if there is upper cervical spine instability that may contribute to compression of upper cervical nerves when upright.
Dynamic X-rays of the cervical spine and MRI are necessary to assess correctly this possibility.
Discuss with your wife's Doctor about getting evaluated further.
Consultations with a spine specialist and a Neurologist are necessary.
Hope you found the answer helpful. Please let me know if I can assist you further.
Take care.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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