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What Causes Constant Headache?

Posted on Thu, 18 Feb 2016

Question: Hi. This past Wednesday, I started to develop a headache which hasn't gone away. It started coming from my neck so I pressed on what I read about called trigger points. The area that was hurting was on the right back of my head right above my hairline. It seemed to help a bit at the time. Then the next day, my head would just hurt when I bent down, cough, sneeze, laugh, etc. and only for a split second. Then they seemed to get better yesterday as long as I didn't move my neck around a whole lot and irritate it. Now, today, I have a constant headache on the right side of my head that feels worse if I lay down. On the back of my neck right above my hairline, there's somewhat of a bump almost like bone sticking out that's not on the other side. Other side is flat. But it's a noticeable bump if I feel it. No pain when I press on it. Just the slight headache that won't go away. Is this something serious??? Could it be possible cancer?

Answered by Dr. Dr. Muhammad Sareer Khalil (2 hours later)

Brief Answer:
Headache

Detailed Answer:
Hello and Welcome

I appreciate your concern

Based on your description , it appears you have been under treated. Ibuprofen 200 mg is a very low dose to treat headache. Ibuprofen 800 mg twice or naproxen 550 mg thrice a day would be more helpful, after consulting your physician. As you say that your headache is worsening, the blood pressure should be checked. A neurological exam should be performed. If there is neck stiffness or any focal deficit then CT scan should be done immediately. The CT should include the para nasal sinuses , too, if advised. If no sinister cause is suspected based on the clinical findings then symptomatic relieve can be provided by IM diclofenac or ketorolac based on availability. An MRI would be a more sensitive and specific test as far as ruling out a malignant lesion is concerned. Please consult a neurologist or your nearest ER for the necessary management.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (8 hours later)

I always have pretty low bp no higher than 120/70. At times, it's 90 or 100/57. Is that a good sign? Or could it still be something serious with low bp? Tonight, I walked around awhile in the cold air, and it seemed to dissipate as long as I was walking around. I also massages my jaw which helped. I sat at the computer after that and about an hour later, it came back. Later on, I walked around outside more. After that, most of it has gone away with elevating my head on the couch with pillows and using an ice pack. It hurts the most if I start moving my head and neck around too much but pain has decreased. I have a history of migraines. With this new information, does it sound like an emergency still? Could the headaches come and go with such problems like an intercranial bleed, problems with a blood vessel or brain tumor? Thanks.I also forgot to mention that I started getting facial twitches a couple months ago with my eyebrow, eye and corner of my mouth. I noticed them after really pushing myself with running though. I'm not sure if that relates. Thanks.

Answered by Dr. Dr. Muhammad Sareer Khalil (4 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

Yes, 120/70 is a suitable range as hypertension is a risk factor for both ischemic and hemorrhagic stroke.

With a history of migraines , its likely to be an acute attack of migraine. There is considerable overlap between headache that is unlikely to be related to a sinister cause and one due to a serious cause such as a space occupying lesion/tumor.

Abortive therapy for acute attack can be advised with sumatriptan or zolmitriptan in combination with naproxen after consulting your doctor. However, based on the triggers for the headache, your doctor would be interested in getting an MRI brain to rule out any serious cause.

The twitching can be due to sleep deprivation, hypo calcemia , headache or anxiety. Calcium, Vitamin D and B 12 levels can be done. Supplementation of the two can be advised accordingly.

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar