Brief Answer:
A trike? Pray tell...what's a TRIKE?

Detailed Answer:
Good afternoon sir. My name is Dr. Saghafi. I'm a neurologist from XXXXXXX OH and Director of the Headache Clinic at the XXXXXXX VA Medical Center who was born in the Great State of New XXXXXXX ...so hello from Out West. I think this one's in my wheelhouse so let's get to it.

I'll make a deal.....I'll tell you what I know about the pain in the back of your head if you'll tell me what a TRIKE is..fair?

Your symptom of a throbbing left sided pain in the back of the head very simply put is more likely than not a migraine type of headache without aura. It could also be something referred to as a Bickerstaff headache. Bickerstaff is more or less an antiquated term but is generally associated with some other symptoms other than just throbbing in the back of the head and most people with Bickerstaff types of headaches complain of them much more frequently than 1-2x/year.

So, honestly, I think you've got a garden variety of migraine headaches. I'll bet you've had these things for a while given your age, am I correct? If that's not true and these are only in the past couple of years and you were PERFECTLY AND COMPLETELY FREE from headaches prior to a few years ago AND you never had bad headaches earlier in life (as a teenager, adolescent, or young adult) which then, disappeared a number of years later.....THEN, I would get a doc to write me an order to get a CT or MRI of the brain because something may be architecturally wrong inside the head.

But something tells me that's probably not the case. I can tell you that even if you did have high blood pressure this would not have anything to do with that sort of problem despite the fact that lots of people (and doctors) think that it does. High blood pressure will only give you a throbbing miserable headache if it goes up RAPIDLY AND UNEXPECTEDLY. If it's a chronic condition then, headaches have nothing to do with them.

The fact that you've found the treatment for them as being simple aspirin, applying pressure, or just relaxing in a sitting position means that I don't need to recite the litany of new fangled drugs which you really don't want to take due to their side effects AND COST.

So that's it in a nutshell....simple, straight forward, hopefully it all makes sense to you.

Diagnosis: Intermittent (yearly) migraine type of headache without aura which responds well to simple analgesic measures.

If these are BRAND NEW to you and are getting worse over the past couple of years or less then, I would get an imaging study of the brain but if this is a chronic thing that you've had going for quite some time without much change then, there's really no need to suck in extra radiation.....I'm sure there's plenty of it around anyways with all the gadgets and nonsense we have with phones, computers, ipods, etc....hey, truth be told...I love the stuff....got at least 3 phones and an ipad on my everywhere I go! And I do mean EVERYWHERE I go!! HA!

If this information has been useful to you would you do me the favor of sending back some written feedback with a STAR RATING? The higher ups like to see that we're answering the questions you ask.

Secondly, if there are no other comments or questions would you mind CLOSING THE QUERY on your end. Again, it's a way the network folks know that I addressed your concerns satisfactorily so they can file this case for future reference or even teaching purposes.

I wish you the best.

This case required 22 minutes of physician specific time to review, research, and document for final draft compilation and envoy.

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Brief Answer:
Understood...thanks for the follow up on trike

Detailed Answer:
Now, that makes sense! You thought you were having a stroke....gotcha.....

Tricycle I knew but it didn't make sense to say you were having a "trike" in the head....now, TCeth...maybe..although I don't think you're drinking antifreeze too much these days are you? But that could probably give you one whale of a headache as well, couldn't it?? HAHA!

Here's some food for thought though...on the issue of stroke and headaches. About 15% of patients who suffer stroke get awful headaches before or at the time of the stroke. However, most of those people also get terrible nausea/vomiting as well and the headaches are usually not amenable to simple aspirin, sitting up, or squeezing the head.

But I can understand in your case if you generally don't get these things that when you do and it's severe you could think something like stroke. If these are chronic and stereotypical (i.e. same characteristics all the time) then, just keep that mind the next time it comes on.....but as I said before, if they are changing or getting decidedly worse for some reason as time goes on then, if I were your neurologist I certainly would take a look see just to satisfy my own curiosity though I'm sure everything will be normal given how easily you treat them and they respond.

Would greatly appreciate your feedback if you do remember with the rating...keeps the questions coming to end of the table you understand....LOL!

Cheers and Be Well!

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Brief Answer:
Nice meeting you

Detailed Answer:
Please don't hesitate on chasing me down for any additional questions you may have on these inconvenient headaches. and keep remembering that that lime green colored XXXXXXX they put in antifreeze is worse than Mountain Dew.

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