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Getting headache, pulsating vessels under eye. Easy way for cure?

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Internal Medicine Specialist
Practicing since : 1998
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I have had a dull headache for a couple of days and now a vein under my right eye is visibly pulsing, I think in time with my heartbeat, although it does seem a little more erratic than a heartbeat. My vision seems okay.
Posted Sat, 25 May 2013 in Headache and Migraines
Answered by Dr. Pankaj Malhan 1 hour later

Thanks for asking.

Pulsatile headache, i.e the headaches along with the pulsating vessels on one side of the face, raises the possibility of two conditions, migraine and temporal arteritis.

Migraine presents with headache with pulsating vessels, mostly unilateral along with/without visual disturbances. It needs medications for relief in the form of ergotamines or sumatriptine.

Typically the headache is unilateral (affecting one half of the head) and pulsating in nature, lasting from 2 to 72 hours. Associated symptoms may include nausea, vomiting, photophobia (increased sensitivity to light), phonophobia (increased sensitivity to sound) and the pain is generally aggravated by physical activity. Up to one-third of people with migraine headaches perceive an aura: a transient visual, sensory, language, or motor disturbance which signals that the headache will soon occur.Occasionally an XXXXXXX can occur with little or no headache following it.

Giant-cell arteritis (GCA or temporal arteritis or cranial arteritis) or Horton disease is an inflammatory disease of blood vessels most commonly involving large and medium arteries of the head. It is more common in women.

Physical exam:

Palpation of the head reveals prominent temporal arteries with or without pulsation.
The temporal area may be tender.
Decreased pulses may be found throughout the body
Evidence of ischemia may be noted on fundal exam.

Laboratory tests:

LFTs, liver function tests, are abnormal particularly raised ALP- alkaline phosphatase
Erythrocyte sedimentation rate, an inflammatory marker, >60 mm/hour (normal 1–40 mm/hour).
C-reactive protein, another inflammatory marker, is also commonly elevated.
Platelets may also be elevated.

Migraine is not such as serious disease, but the possibility of temporal arteritis advocates investigations to rule out this condition as It can lead to blindness if left untreated, so the diagnosis and the treatment needs to be quick to prevent the serious outcome.

Please consult your doctor for the physical examination and investigations.

Thanks, I am happy to take follow up queries if any.
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