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What Causes Persistant Headache On The Right Side Of Head?
Question: Hi. I have had a persistant headache in the right side of my head for a week now. It has spread from time to time to the left, but it is always centered in one position. I have been to see a doctor, who said he didn't know what it was, but to come back in a week. He did bloods and found no sign of infection. I have been feeling a bit nauseous and the right side of my head feels 'Heavy'. I am very concerned as a friend of mine died of a brain tumour whose first symptom was a persistent headache. Should I be worried?
Brief Answer:
Probably tension headache. If persistent - imaging
Detailed Answer:
I read your question and I understand your concern.
By reading your description of the symptoms, the most likely diagnosis seems to be tension type headache. It is very common and a primary headache (meaning no cause can be identified). It is managed with over the counter painkillers like Ibuprofen and relaxation techniques because stress is the main triggering or exacerbating factor. In chronic cases preventive treatment with Amitriptyline is followed.
However, headache is at times a presentation of brain lesions. Usually in these cases it is associated with other symptoms depending on lesion location like weakness or sensation changes in the limbs, visual disturbances, loss of balance, behavior changes, seizures etc. Since you don't have such symptoms you shouldn't panic.
If the pain is persistent and doesn't respond to pain killers a neurological exam for more subtle neurologic signs is recommended. If such signs are found brain imaging with CT or ideally MRI is necessary.
Other causes to require imaging even in the absence of signs could be: headache progressively increasing in intensity, headache waking up from sleep, headache exacerbated by manoeuvres like coughing, or headache in someone who never had headaches previously, failure to respond to painkillers.
I remain at your disposal for further questions.
Probably tension headache. If persistent - imaging
Detailed Answer:
I read your question and I understand your concern.
By reading your description of the symptoms, the most likely diagnosis seems to be tension type headache. It is very common and a primary headache (meaning no cause can be identified). It is managed with over the counter painkillers like Ibuprofen and relaxation techniques because stress is the main triggering or exacerbating factor. In chronic cases preventive treatment with Amitriptyline is followed.
However, headache is at times a presentation of brain lesions. Usually in these cases it is associated with other symptoms depending on lesion location like weakness or sensation changes in the limbs, visual disturbances, loss of balance, behavior changes, seizures etc. Since you don't have such symptoms you shouldn't panic.
If the pain is persistent and doesn't respond to pain killers a neurological exam for more subtle neurologic signs is recommended. If such signs are found brain imaging with CT or ideally MRI is necessary.
Other causes to require imaging even in the absence of signs could be: headache progressively increasing in intensity, headache waking up from sleep, headache exacerbated by manoeuvres like coughing, or headache in someone who never had headaches previously, failure to respond to painkillers.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Hi. Is there any chance it could be sinus related, even though there was no sign of infection? I have a feeling of pressure behind my nose and sometimes feel as if 'a 'bubble' has popped at the top of my nose which seems to relieve the pressure. Also a couple of years ago, I had treatment for high NK and TNF alpha cells due to repeat miscarriage. Could these have been high due to my body trying to fight a cancerous growth? Thank you!
Brief Answer:
Sinusits can cause that sort of pain.
Detailed Answer:
Sinusitis can show that type of headache you describe, I didn't mention it because you had thought about it yourself and your doctor seemed to have excluded that during his examination. As for the fact that you say "sinusitis drugs seem to help", it depends on what drugs you mean, Ibuprofen for example is often used for sinusitis combined with nasal vaso-constrictors, but it would work also for other types of headache.
As for the high NK and TNF alpha, those are elevated in many types of inflammations their elevation is not specific. They could be related to cancer but their role and level interpretation is still subject of studies, TNF for example is debated whether cancer promoting by inducing cell proliferation or cancer protecting by killing tumoral cells. So really no conclusions can be drawn.
On a practical level the possibility of cancer being involved is very unlikely given the fact that more then two years have passed (since they were related to your repeat miscarriages then their cell expression was elevated in previous miscarriages as well). It's too long a time for a hidden cancer being at the root of those elevated levels, would have manifested in the meantime.
I hope to have been of help.
Sinusits can cause that sort of pain.
Detailed Answer:
Sinusitis can show that type of headache you describe, I didn't mention it because you had thought about it yourself and your doctor seemed to have excluded that during his examination. As for the fact that you say "sinusitis drugs seem to help", it depends on what drugs you mean, Ibuprofen for example is often used for sinusitis combined with nasal vaso-constrictors, but it would work also for other types of headache.
As for the high NK and TNF alpha, those are elevated in many types of inflammations their elevation is not specific. They could be related to cancer but their role and level interpretation is still subject of studies, TNF for example is debated whether cancer promoting by inducing cell proliferation or cancer protecting by killing tumoral cells. So really no conclusions can be drawn.
On a practical level the possibility of cancer being involved is very unlikely given the fact that more then two years have passed (since they were related to your repeat miscarriages then their cell expression was elevated in previous miscarriages as well). It's too long a time for a hidden cancer being at the root of those elevated levels, would have manifested in the meantime.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Prasad
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