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Suggest Treatment For Severe Headache
Question: Dear Doctor
My daughter is having severe headache. and normally she got 2 or 3 attack per day. and after headaches she vomited. in the attached time we can't control her. pain is above eyes. we have done some blood test and MRI, MRA and CT scane. MRI report shows ''small focus of ischemic gliosis is seen on the right corona radiata. There is mild mucosal thickening of the bilateral ethmoid sinuses.Blood report shows hight platelets, it ia 968000.. I have showed her to hospital and they admitted her and give some treatment and discharged. But still same problem nothing improved. her age is 9yrs. and this headaches started on 10th December 2015.
And they give some more test to do, but that all test results not received yet.
I'm very tension because of nothing improve. I have attached some blood test and discharged summary.
please tell me why this severe headaches is?
Thanks
My daughter is having severe headache. and normally she got 2 or 3 attack per day. and after headaches she vomited. in the attached time we can't control her. pain is above eyes. we have done some blood test and MRI, MRA and CT scane. MRI report shows ''small focus of ischemic gliosis is seen on the right corona radiata. There is mild mucosal thickening of the bilateral ethmoid sinuses.Blood report shows hight platelets, it ia 968000.. I have showed her to hospital and they admitted her and give some treatment and discharged. But still same problem nothing improved. her age is 9yrs. and this headaches started on 10th December 2015.
And they give some more test to do, but that all test results not received yet.
I'm very tension because of nothing improve. I have attached some blood test and discharged summary.
please tell me why this severe headaches is?
Thanks
Brief Answer:
Requires investigations for diagnosis, continue treatment and pain killers
Detailed Answer:
Hello XXXX,
I have gone through you question and reports and understand your concerns.
The most problematic report is raised platelet counts.
The headache in this age may be associated with migraine but in view of abnormal platelet and MRI report it is important to evaluate for secondary causes of headache.
The main focus should be diagnosis for raised platelet counts.
Essential thromobocytosis or secondary causes have to be evaluated in details.
The work up is extensive and best if done under guidance of hemato-oncologist.
Though platelet sometimes increase after some infection too but other serious oncological, immune causes should be evaluated.
As far as reports done till now are not pointing to some specific aetiology.
Required investigations are c XXXXXXX pANCA, bone marrow.
Repeat platelet counts.
For treatment of headache , pain killers, hydration to be continued.
Aspirin to be continued for prevention of stroke.
Mri report of sinus mucosal thickening is common in most person and may not be related to present symptoms.
Consult a hemato-oncologist in your country or else have a consultation from Tata memorial hospital XXXXXXX XXXXXXX Timely diagnosis is important and delay will be harmful.
Hope you found the answer helpful.
Do get back with further queries.
Regards
Dr N Kumar
Neurologist
Requires investigations for diagnosis, continue treatment and pain killers
Detailed Answer:
Hello XXXX,
I have gone through you question and reports and understand your concerns.
The most problematic report is raised platelet counts.
The headache in this age may be associated with migraine but in view of abnormal platelet and MRI report it is important to evaluate for secondary causes of headache.
The main focus should be diagnosis for raised platelet counts.
Essential thromobocytosis or secondary causes have to be evaluated in details.
The work up is extensive and best if done under guidance of hemato-oncologist.
Though platelet sometimes increase after some infection too but other serious oncological, immune causes should be evaluated.
As far as reports done till now are not pointing to some specific aetiology.
Required investigations are c XXXXXXX pANCA, bone marrow.
Repeat platelet counts.
For treatment of headache , pain killers, hydration to be continued.
Aspirin to be continued for prevention of stroke.
Mri report of sinus mucosal thickening is common in most person and may not be related to present symptoms.
Consult a hemato-oncologist in your country or else have a consultation from Tata memorial hospital XXXXXXX XXXXXXX Timely diagnosis is important and delay will be harmful.
Hope you found the answer helpful.
Do get back with further queries.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks sir.
That test doctor advised is done and got report. it is
ANTI NUCLEAR ANTIBODIES:
ANA HEp-2 TITRE: 1:40 (Negative)
 ANTI - ds DNA ANTIBODY, SERUM (EIA): 9.96IU/ml.
 p-ANC;ANTI MYELOPEROXIDASE ANTIBODY, SERUM: 2.34 U/ml.
PHOSPHOLIPID ANTIBODY PANEL SERUM:
    IgG: 2.21 GPL U/ml
    IgM: 2.18 MPL U/ml.
But from my country (Maldives) we can't do bone marrow test. now also she got sever headache minimum once in per day. but now little more vomiting. but from here doctor didn't give any medicine for that problem. only they give paracetamol and emeset tab.
I really don't know what to do?
That test doctor advised is done and got report. it is
ANTI NUCLEAR ANTIBODIES:
ANA HEp-2 TITRE: 1:40 (Negative)
 ANTI - ds DNA ANTIBODY, SERUM (EIA): 9.96IU/ml.
 p-ANC;ANTI MYELOPEROXIDASE ANTIBODY, SERUM: 2.34 U/ml.
PHOSPHOLIPID ANTIBODY PANEL SERUM:
    IgG: 2.21 GPL U/ml
    IgM: 2.18 MPL U/ml.
But from my country (Maldives) we can't do bone marrow test. now also she got sever headache minimum once in per day. but now little more vomiting. but from here doctor didn't give any medicine for that problem. only they give paracetamol and emeset tab.
I really don't know what to do?
Brief Answer:
Reports seems to be normal
Detailed Answer:
Hello, Welcome back to HCM.
Please upload the original reports for lab cut off values too.
If the Platelet count doesn't decrease in 2-4 weeks then further workup is required under a hemato-oncologist.
Naproxen with Ondensteron can be given for headache and vomiting.
Also it's very important to maintain good hydration.
Regards
Dr N Kumar
Neurologist
Reports seems to be normal
Detailed Answer:
Hello, Welcome back to HCM.
Please upload the original reports for lab cut off values too.
If the Platelet count doesn't decrease in 2-4 weeks then further workup is required under a hemato-oncologist.
Naproxen with Ondensteron can be given for headache and vomiting.
Also it's very important to maintain good hydration.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you sir.
I have attached that reports.
i have done some urine test today. and it shows some pus cells. 10-15. and bacteria +++.
Know headache is less. but abdomen pain with vomiting is there.
Thank you
I have attached that reports.
i have done some urine test today. and it shows some pus cells. 10-15. and bacteria +++.
Know headache is less. but abdomen pain with vomiting is there.
Thank you
Brief Answer:
Antibiotics may be required
Detailed Answer:
Hello,
Urine infection require culture and sensitivity testing.
Was she catheterised in hospital?
Antibiotics may be required.
Rest advice to be followed as discussed earlier.
Regards
Dr N Kumar
Neurologist
Antibiotics may be required
Detailed Answer:
Hello,
Urine infection require culture and sensitivity testing.
Was she catheterised in hospital?
Antibiotics may be required.
Rest advice to be followed as discussed earlier.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Sonia Raina
Thank you sir
From here we can't do urine culture we have to our country main hospital. so it need some time. (days).
Not catheterise...
and sorry for not attach report. it is because of network problem. now i will try to upload.
Regards sir
From here we can't do urine culture we have to our country main hospital. so it need some time. (days).
Not catheterise...
and sorry for not attach report. it is because of network problem. now i will try to upload.
Regards sir
Brief Answer:
Give antibiotics after culture
Detailed Answer:
Hello,
If there is no fever or urinary frequency then wait for culture report else give appropriate antibiotics after discussing with the treating doctor.
Upload reports when possible.
I am here to advise best possible step.
Regards
Dr N Kumar
Neurologist
Give antibiotics after culture
Detailed Answer:
Hello,
If there is no fever or urinary frequency then wait for culture report else give appropriate antibiotics after discussing with the treating doctor.
Upload reports when possible.
I am here to advise best possible step.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you sir.
at this time they give some medicine also. it is:
Tab. Azithromycin 250mg
syp. uphamol 250mg
syp. Alkaline citrate
Tab. Pantoprazole 20mg
Syp. Colispasm (SOS)
Syp. Domperidone.
Is this good medicine for this time?
Thanks
at this time they give some medicine also. it is:
Tab. Azithromycin 250mg
syp. uphamol 250mg
syp. Alkaline citrate
Tab. Pantoprazole 20mg
Syp. Colispasm (SOS)
Syp. Domperidone.
Is this good medicine for this time?
Thanks
Brief Answer:
Continue the medicines prescribed by your doctor
Detailed Answer:
Hello,
The medicine prescribed is good for urine infection. Continue the same.
Regards
Dr N Kumar
Continue the medicines prescribed by your doctor
Detailed Answer:
Hello,
The medicine prescribed is good for urine infection. Continue the same.
Regards
Dr N Kumar
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you sir.
I have attached previous test you told (cANCA, pANCA...).
Is there anything wrong about that test?
Regards sir
I have attached previous test you told (cANCA, pANCA...).
Is there anything wrong about that test?
Regards sir
Brief Answer:
Normal reports
Detailed Answer:
Hello,
Both reports are normal.
Get consultation from a hemato-oncologist.
Further work up require expert opinion and investigation as suggested previously.
Regards
Dr N Kumar
Neurologist
Normal reports
Detailed Answer:
Hello,
Both reports are normal.
Get consultation from a hemato-oncologist.
Further work up require expert opinion and investigation as suggested previously.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you sir.
Today we reported platelets. and it shows normal.
Hb: 11.6
PCV: 35
Platelet count: 218,000.
From Maldives there is no hemato-oncologist.
I have ask a question from this app with hemato-oncologist. but still no response.
Thanks sir
Today we reported platelets. and it shows normal.
Hb: 11.6
PCV: 35
Platelet count: 218,000.
From Maldives there is no hemato-oncologist.
I have ask a question from this app with hemato-oncologist. but still no response.
Thanks sir
Brief Answer:
Wait for further work up
Detailed Answer:
Hello,
If present platelet count is normal then wait for sometime.
How many times platelet count measured previously?
Was the reports from same labs or different?
Is the present report from previous lab?
Regards
Dr N Kumar
Neurologist
Wait for further work up
Detailed Answer:
Hello,
If present platelet count is normal then wait for sometime.
How many times platelet count measured previously?
Was the reports from same labs or different?
Is the present report from previous lab?
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Sonia Raina
This is detail reports with date.
11/12/2015. 947000 (From ADK Hospital)
12/12/2015. 845000 (From ADK hospital)
12/12/2015. 789000 (From ADK hospital)
12/12/2015. 150000 (From IGMG hospital)
14/12/2015. 968000 (From ADK hospital)
27/12/2015. 218000 (From MULAK health center).
This is reports done to test platelets. It is done in three different laboratory. It is mentioned above.
Thanks
11/12/2015. 947000 (From ADK Hospital)
12/12/2015. 845000 (From ADK hospital)
12/12/2015. 789000 (From ADK hospital)
12/12/2015. 150000 (From IGMG hospital)
14/12/2015. 968000 (From ADK hospital)
27/12/2015. 218000 (From MULAK health center).
This is reports done to test platelets. It is done in three different laboratory. It is mentioned above.
Thanks
Brief Answer:
Repeat manual platelet counts from another authentic lab
Detailed Answer:
Hello,
All the report from ADK hospital are raised while other lab shows normal report.
I will recommend you to get it investigated from another authentic lab with manual platelet counts too.
Sometimes automatic analyser have some fault.
Regards
Dr N Kumar
Neurologist
Repeat manual platelet counts from another authentic lab
Detailed Answer:
Hello,
All the report from ADK hospital are raised while other lab shows normal report.
I will recommend you to get it investigated from another authentic lab with manual platelet counts too.
Sometimes automatic analyser have some fault.
Regards
Dr N Kumar
Neurologist
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Yogesh D
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