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What Causes Soreness And Dull Pain In The Head On The Right Side?

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Posted on Wed, 7 Dec 2016
Question: For several weeks I have had soreness, sort of dull pin on the right side of my skull extending from the back edge of slull most of the way to my hair line at front. Only on the right side. Male 72 years of age. Taking ELiquis for Afib for 8 months now.
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Answered by Dr. Dariush Saghafi (4 hours later)
Brief Answer:
See a headache specialist for a good diagnosis

Detailed Answer:
Good evening. Based upon your description of symptoms I would say that your picture fits into either a very very mild headache with migraine features which also has some features consistent with tension type headaches.

Or you may have a very very mild case of HEMICRANIA CONTINUA which is a type of headache which when severe can cause exquisite pain over exactly HALF of the head as you describe and can last constantly for weeks or even months at a time. The diagnosis of such a headache is important because treatments are different from standard tension or migraine headaches and usually involve either drugs such as indomethacin, steroids, or lithium. As a headache specialist and neurologist I very much try and avoid LITHIUM in patients since it can cause kidney problems as well as the fact that lithium constantly accumulates in the body without ever being metabolized out.....it's actually a metallic substance and I just hate the idea of using drugs like that which simply build up.

But a good headache specialist will take a very detailed history from you on this headache, find out if you've had other headaches in the past and how long ago, get a family history from you on headaches, and have you keep a HEADACHE DIARY or log. In that way the specific diagnosis can be more easily and efficiently obtained which will allow the best therapeutic interventions to be considered.

Not only that....but a good headache doctor will do their best to discover the CAUSE of the headache since it is rare to find SUDDEN SEVERAL WEEK in duration headaches in a person who either had no problem to begin with or perhaps has a headache history in the remote past which is now coming back....the trick would be to figure out what is tripping this off now. Therefore, if a neurological examination reveals some focal brain deficit that coincides with the timing of when this all began then, it would probably behoove you to get an imaging study of the brain such as a CT or MRI.

I would also recommend considering an echocardiogram study be done if you have A-fib (preferablly a Transesophageal type) because we would want to know if there is any fixed thrombus in the left atrial appendage which could be potentially causing a rain of small emboli through the right internal carotid system which could theoretically cause hemicranial pain as you describe.

If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.

I would also recommend getting a standard metabolic workup to include THYROID FUNCTION STUDIES (FT4, TSH) as it is known that both HYPO as well as HYPERTHYROIDISM (more likely in the setting of A-fib) can cause headaches of any variety....even yours which are just dull in nature.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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What Causes Soreness And Dull Pain In The Head On The Right Side?

Brief Answer: See a headache specialist for a good diagnosis Detailed Answer: Good evening. Based upon your description of symptoms I would say that your picture fits into either a very very mild headache with migraine features which also has some features consistent with tension type headaches. Or you may have a very very mild case of HEMICRANIA CONTINUA which is a type of headache which when severe can cause exquisite pain over exactly HALF of the head as you describe and can last constantly for weeks or even months at a time. The diagnosis of such a headache is important because treatments are different from standard tension or migraine headaches and usually involve either drugs such as indomethacin, steroids, or lithium. As a headache specialist and neurologist I very much try and avoid LITHIUM in patients since it can cause kidney problems as well as the fact that lithium constantly accumulates in the body without ever being metabolized out.....it's actually a metallic substance and I just hate the idea of using drugs like that which simply build up. But a good headache specialist will take a very detailed history from you on this headache, find out if you've had other headaches in the past and how long ago, get a family history from you on headaches, and have you keep a HEADACHE DIARY or log. In that way the specific diagnosis can be more easily and efficiently obtained which will allow the best therapeutic interventions to be considered. Not only that....but a good headache doctor will do their best to discover the CAUSE of the headache since it is rare to find SUDDEN SEVERAL WEEK in duration headaches in a person who either had no problem to begin with or perhaps has a headache history in the remote past which is now coming back....the trick would be to figure out what is tripping this off now. Therefore, if a neurological examination reveals some focal brain deficit that coincides with the timing of when this all began then, it would probably behoove you to get an imaging study of the brain such as a CT or MRI. I would also recommend considering an echocardiogram study be done if you have A-fib (preferablly a Transesophageal type) because we would want to know if there is any fixed thrombus in the left atrial appendage which could be potentially causing a rain of small emboli through the right internal carotid system which could theoretically cause hemicranial pain as you describe. If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out. I would also recommend getting a standard metabolic workup to include THYROID FUNCTION STUDIES (FT4, TSH) as it is known that both HYPO as well as HYPERTHYROIDISM (more likely in the setting of A-fib) can cause headaches of any variety....even yours which are just dull in nature. Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.