Hello! Thank you for asking on HCM! I would explain that Ice pick headache, also called primary stabbing headaches are not very compatible with her symptoms. This is a benign type of headache, which is not associated to other symptoms like loud ringing noise and nose bleeding. Have you measured her blood pressure during these episodes? Uncontrolled high blood pressure could be related to this symptomatology. I would recommend consulting with a neurologist and performing a brain CT scan or MRI to exclude possible intracranial causes of this symptomatology. The nose bleeding and the unilateral localised pain, raises suspicions of possible intracranial cause. Hope you will find this answer helpful! Kind regards, Dr. Aida