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Suggest Treatment For Severe Headache
Question: Hi I had a flu/cold/chest congestion 2 weeks ago, followed by an intestinal virus last week, threw up no stop for 3 days, then have been very weak for the last 10 days, and with migraines. Fever is gone, I just checked my blood pressure/heart rate is at 150-95 / 90 (usually is at 133-88 / 80) so a little high
So despite most symptoms are gone, the sharp pain along the right parietal top of the head remains and does not go away regardless of pain meds. i haven't been able to work for 9 days, though i have treated everything, including migraines but that sharp pain on top of the head does not react to any medication, and is especially strong when lying down. could it be a popped vessel that popped due to the constant effort of throwing up for days? Anything else of concern? if so should i consult? use of an MRI? veinous MRI?
So despite most symptoms are gone, the sharp pain along the right parietal top of the head remains and does not go away regardless of pain meds. i haven't been able to work for 9 days, though i have treated everything, including migraines but that sharp pain on top of the head does not react to any medication, and is especially strong when lying down. could it be a popped vessel that popped due to the constant effort of throwing up for days? Anything else of concern? if so should i consult? use of an MRI? veinous MRI?
Brief Answer:
No alarming symptoms.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from your description I have to say that it is unlikely for the pain to be due to a brain lesion such as a hemorrhage or infarction. Usually there are other symptoms in these cases associated with the headache such as weakness or numbness of the limbs on one side, balance and coordination difficulties, double vision or visual loss, seizures, confusion and behavior changes etc. In the absence of such symptoms brain lesion is unlikely.
Given the respiratory and digestive infections you have had some headache may commonly follow. The fatigue you mention is also a common aftermath of viral infection. Vomiting leading to dehydration is a contributing factor as well. So I wouldn't be overworried.
If the headache persists without at least reducing its intensity then however at some point the possibility of an uncommon manifestation with only headache should be considered and some testing be done. So if not improving for at least two weeks some more attention is required and brain imaging considered. MRI is great if you can get it easily but is not available everywhere or at least not on an emergency basis. I think a CT would provide the necessary information just as well though in this case. So if no improvement on the following weeks (from what I understand pain has appeared only last week) a re-evaluation in the ER for other signs you might have missed and a CT would be advisable.
One exception which might require a more urgent evaluation would be if the onset of the headache was very abrupt, reaching its maximum intensity in a matter of seconds. That would be a strong indicator for hemorrhage and should get a CT and evaluation for neurological signs even in the absence of any other symptoms. Of course if any of the symptoms I mentioned before appear that would be a cause for urgent evaluation as well.
I remain at your disposal for other questions.
No alarming symptoms.
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from your description I have to say that it is unlikely for the pain to be due to a brain lesion such as a hemorrhage or infarction. Usually there are other symptoms in these cases associated with the headache such as weakness or numbness of the limbs on one side, balance and coordination difficulties, double vision or visual loss, seizures, confusion and behavior changes etc. In the absence of such symptoms brain lesion is unlikely.
Given the respiratory and digestive infections you have had some headache may commonly follow. The fatigue you mention is also a common aftermath of viral infection. Vomiting leading to dehydration is a contributing factor as well. So I wouldn't be overworried.
If the headache persists without at least reducing its intensity then however at some point the possibility of an uncommon manifestation with only headache should be considered and some testing be done. So if not improving for at least two weeks some more attention is required and brain imaging considered. MRI is great if you can get it easily but is not available everywhere or at least not on an emergency basis. I think a CT would provide the necessary information just as well though in this case. So if no improvement on the following weeks (from what I understand pain has appeared only last week) a re-evaluation in the ER for other signs you might have missed and a CT would be advisable.
One exception which might require a more urgent evaluation would be if the onset of the headache was very abrupt, reaching its maximum intensity in a matter of seconds. That would be a strong indicator for hemorrhage and should get a CT and evaluation for neurological signs even in the absence of any other symptoms. Of course if any of the symptoms I mentioned before appear that would be a cause for urgent evaluation as well.
I remain at your disposal for other questions.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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