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Suggest Remedy For Severe Headache In A Person With Macular Degeneration

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Posted on Thu, 3 Dec 2015
Question: Headache every day with feverish scalp, top left side of my head. I had a stroke (vertebral artery dissection) 17 years ago caused by a chiropractic neck manipulation. These particular headaches started this summer. I also have wet macular degeneration & receive shots (Eyelea) every six weeks. Could these be the cause of my headaches?
doctor
Answered by Dr. Neeraj Kumar (20 minutes later)
Brief Answer:
Provide more clinical details for diagnosis

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
Headache in this age may be due to tension type, migraine or temporal arteritis.
Other less common causes may also lead to headache.
Provide more details regarding headache:
1) Duration
2) Intensity--mild, mod, severe
3) character -- throbbing, bursting, piercing
4) associated features: nausea, vomiting, photophobia, phonophobia
5) Aggravating factors
6) releiving factors
7) vision
8) anxiety
9)sleep disturbances
10 ) previous history of migraine
11) any neurological deficit
Do get back with these details for further analysis and diagnosis.
Regards
Dr Neeraj Kumar
neurologist
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Neeraj Kumar (2 hours later)
Hello Dr. XXXXXXX
More information per your request.
1)Duration - Headaches last from mid-day to evening
2)Intensity - Moderate
3)Character - Starts out piercing then dull ache
4)Photophobia - slight to moderate - (different from previous migraines)
5)aggravating factors - computer work, etc.
6)relieving factors (tylenol or advil help some with pain)
7)vision - not real clear
8)anxiety - nothing unusual
9)sleep disturbances - pain prevents sleep at times
10)previous history of migraines - some migraines, but mostly headaches associated to stroke issues - Some rebound headaches - Current headaches involve a feverish spot on my scalp
11)neurological deficit - stroke related (memory issues, short & long term, loss of fine motor skills on my left side, left vocal cord paralyzed)
I had brain surgery in 1998, (VAD/stroke) part of the cerebellum, and the dura-matter were removed to allow for swelling. Hospitalized, rehab, etc. Took 2 years to walk & talk appropriately again. I have tremors in my left hand & left leg when challenged physically or I am tired.
I have also had several episodes of vertigo recently. Dramamine helped some with the symptoms. I have had issues in the past with crystals coming dislodged in my ear and I know how to do the Epley maneuver, but the recent vertigo is different & the Epley maneuver does not help.
Thank you for your help.
Joni XXXXXXX
doctor
Answered by Dr. Neeraj Kumar (13 hours later)
Brief Answer:
VISIT A NEUROLOGIST AND GET BRAIN IMAGING DONE

Detailed Answer:
Hello,
With such a history of headache and background of migraine, I will keep first possibility of migraine headache as it has varied presentation.
Other possibility of secondary headache can be ruled out by examination and imaging of brain.
In view of previous stroke and vertigo it will be good to get a neuroimaging done.
For treatment you can try migraine prophylaxis by taking either propranolol, Flunarizine, amitryptiline, Topiramate, Valproate.
Pain killers may be taken occasionally as needed.
Continue other medications for stroke and tremors.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2259 Questions

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Suggest Remedy For Severe Headache In A Person With Macular Degeneration

Brief Answer: Provide more clinical details for diagnosis Detailed Answer: Hello, I have gone through your question and understand your concerns. Headache in this age may be due to tension type, migraine or temporal arteritis. Other less common causes may also lead to headache. Provide more details regarding headache: 1) Duration 2) Intensity--mild, mod, severe 3) character -- throbbing, bursting, piercing 4) associated features: nausea, vomiting, photophobia, phonophobia 5) Aggravating factors 6) releiving factors 7) vision 8) anxiety 9)sleep disturbances 10 ) previous history of migraine 11) any neurological deficit Do get back with these details for further analysis and diagnosis. Regards Dr Neeraj Kumar neurologist