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Having severe headache, nausea and slight fever. Worst while moving. Does any virus cause severe headache?

DOCTOR OF THE MONTH - May 2014
May 2014
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My daugher is 37 years old and healthy. For the past six days she has had a severe headache. She went to the doctor who sent her to the emergency room where they ruled out menigitis. They basically told her she had a virus and sent her home. No pain medication helps and she is at the end of her rope. What should she do and have you heard of a virus that would cause this type of headache for so long? She has had slight nausea and a fever around 100 but not consistantly. If she is lying down it is tolerable, but when she starts standing and moving around it becomes worse again.
Posted Wed, 30 Oct 2013 in Headache and Migraines
 
 
Answered by Dr. Vivek Chail 1 hour later
Brief Answer:
Please find detailed answer below.

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.

With a history of severe headache for 6 days and 100 fever, there are many causes to be considered clinically. Ruling out meningitis does not rule out other causes and your daughter might need through clinical examination by a neurologist.

She might be experiencing spinal headaches which are a type of headache that occurs when the pressure in the skull becomes low, usually from a loss of the spinal fluid that surrounds the brain and the nerves in the spine. The headache that results from a loss of spinal fluid is unique in that the headache is much worse when standing, and almost resolves by simply lying down.

A headache patient needs to be examined completely for causes in the brain and/ or spine.

An imaging investigation like CT scan or a MRI scan would be necessary to rule out any significant condition in the brain which is causing the headache. Infection of the nervous system can involve the meninges (meningitis) or the brain substance itself (encephalitis), or both (meningoencephalitis). Additionally, infections can be acute or chronic. The organisms that are involved in infection are bacterial, parasitic or viral. Non infective causes must also be evaluated at the same time.

Laboratory tests like lumbar puncture may be required to confirm diagnosis.

If headache is severe and not showing signs of improvement and worsening with time, please have your daughter seen by a neurologist immediately.

Hope your query is answered.
Do write back in case of doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by
 
Follow-up: Having severe headache, nausea and slight fever. Worst while moving. Does any virus cause severe headache? 8 hours later
Thank you for your reply. She already had a spinal tap in order to rule out meningitis. Would the spinal fluid indicate any of these other conditions that you reference in your reply?
 
 
Answered by Dr. Vivek Chail 49 minutes later
Brief Answer:
Spinal tap might cause headache

Detailed Answer:
Hi,
Thanks for writing in to us.

The spinal tap is an important clinical test to diagnose neurological infections. Infections might be bacterial or viral. The spinal tap itself can cause headaches which worsens on standing or moving around. If spinal tap Iis negative for meningitis then it is almost confirmatory. Most viral infections are self limited and resolve with rest and care.

I still feel the headache is due to spinal tap and is seen in many patients.

Hope your query is answered.
Do write in case of doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by
 
Follow-up: Having severe headache, nausea and slight fever. Worst while moving. Does any virus cause severe headache? 42 minutes later
Thank you. She went for the spinal tap because she had the headache. Perhaps the spinal tap is prolonging the headache. Do you still suggest CT scan or MRI?
 
 
Answered by Dr. Vivek Chail 4 hours later
Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi,
You are welcome and thanks for writing in again.

You might be right, the spinal tap is prolonging the headache and causing it to intensify on standing and moving about.

CT scan or MRI scan is needed after a consultation with a Neurologist if they feel its necessary. The important features which necessitate CT or MRI scan are:
1. Vomiting
2. Loss of consciousness
3. Loss of balance
4. Severe headache
5. Neck rigidity and high fever
6. Loss of speech and vision
7. Loss of sensation and paralysis

Hope your query is answered.
Do write in case of doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by
 
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