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Suggest Treatment For Severe Headaches
Question: I started out yesterday with an extreme headache in the left parietal ridge area. It was as if the skull was pushing out. It was left side only. It started out as minor and went to debilitating in about 1/2 hour. I was seen in the emergency room and diagnosed with tension migraine. Headache is less severe but skull on left side is point tender on the parietal ridge.
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
First of all that blood pressure you mention is a little alarming. While it seems that fortunately there were no acute complications due to it those values indicate that you should monitor it closely as you might need regular treatment. Such values in themselves can cause headache, so may have at least partially contributed. Fortunately the CT was normal which excludes complications like brain hemorrhage or other brain lesions, so you should feel reassured in that sense.
Such tenderness upon pressing on the skull is commonly associated with tension type headache. On the other hand the pain on only one side is more typical of migraine, so having characteristics of both types of headache are I suppose what led the doctors at the diagnosis of a mixed headache, tension migraine. I wonder whether you have a history of headache in the past, you provide no info on that.
Advil is a good initial medication, other over the counter medication like Excedrin may be used as well. If you have used Advil only yesterday I would give it another try today the pain is milder and more of the tension type.
If it still doesn't work then the recommended medication for these mixed type of headache are the triptan class of medication, like zolmitriptan or sumatriptan.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
First of all that blood pressure you mention is a little alarming. While it seems that fortunately there were no acute complications due to it those values indicate that you should monitor it closely as you might need regular treatment. Such values in themselves can cause headache, so may have at least partially contributed. Fortunately the CT was normal which excludes complications like brain hemorrhage or other brain lesions, so you should feel reassured in that sense.
Such tenderness upon pressing on the skull is commonly associated with tension type headache. On the other hand the pain on only one side is more typical of migraine, so having characteristics of both types of headache are I suppose what led the doctors at the diagnosis of a mixed headache, tension migraine. I wonder whether you have a history of headache in the past, you provide no info on that.
Advil is a good initial medication, other over the counter medication like Excedrin may be used as well. If you have used Advil only yesterday I would give it another try today the pain is milder and more of the tension type.
If it still doesn't work then the recommended medication for these mixed type of headache are the triptan class of medication, like zolmitriptan or sumatriptan.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have had headaches similar to this in the past. But I had not sought medical attention for those. They also were on the parietal ridge but on the right side. None of these were as severe as yesterday's episode. I would usually just rest until the headache was gone, sometimes up to 3 days. It has been quite awhile since I have had this kind of headache. I do not have a history of hypertension and normally run around 110/70.
Brief Answer:
Read below
Detailed Answer:
Thank you for the additional information!
The fact that you've had similar though less intense headaches in the past together with the normal CT is further reassuring regarding the absence of any brain lesions.
I still think you should monitor your blood pressure in the next couple of weeks. Blood pressure may increase in situations of stress but 200/160 is very high so deserves some extra observation.
As for the treatment of the pain itself the previous recommendations remain.
Let me know if I can further assist you.
Read below
Detailed Answer:
Thank you for the additional information!
The fact that you've had similar though less intense headaches in the past together with the normal CT is further reassuring regarding the absence of any brain lesions.
I still think you should monitor your blood pressure in the next couple of weeks. Blood pressure may increase in situations of stress but 200/160 is very high so deserves some extra observation.
As for the treatment of the pain itself the previous recommendations remain.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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