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Persistent Strong Headache, High Blood Pressure. Cause And Solution?
My 48 year old mother has persistent strong headaches for over 20 years now. She was also diagnosed with high blood pressure. She usually takes pain killers bt it persists sometyms, though at times she can get some relief. She has a headaches twice or thrice a week. What is the cause of this and what can we do about it?
Fri, 11 Jan 2013
Hello,
i am a neurologist and thanks for posting this question in this web site
The causes of headache are so many and the approach to any patient with headache begins with a search for the exact cause of headache. The common causes of headache are migrain, tension headache, brain infection, tumor or problems in the blood vessels of the brain and so on.
Back to your question, the long duration of headache without any other symptoms (only you have posted headache, you have not told us which part of head, is there vomiting or other symptoms during headache or not) may suggest a possibility of migrain. How ever, one has to understand that migrain is a diagnosis of exclusion (the above cause need exclusion before we say that headache is due to migrain). If a CT scan rules out these possibility, the diagnosis of migrain will be confirmed.
Coming to the management of migrain, there are two aspects 1. To treat the acute and severe episodes- this can be treated with analgesics. other medicines which can be used are triptans provided that you donot have any cardiac problem.2. To terat the chronic phase or the medicines that can modify the headache-for this the options are sodium valproate, (this drug has a good evidence for this headache, but in females it may cause weight gain, menstrual irregularities), topiramate (it cause weight loos too, may be a good options if you are obese), amitryptiline, propranolol, atenolol etc. Apart from this one has to find out what triggers the headache like stress, food, perfumes , chocollate, coffee. These life style modificationa also help decrease the headache.
Hope this clarifies. If there is no recent change in the character of headache, you donot have to worry much. As your mum has hypertension alo, i think the medicine which can help will be atenolol or propranolol. She can start atenolol 50 mg for 7 days and increase to 100mg later. Make sure that she does not have asthma before giving this drug and you have to monitor her heart rate while being on this medicine.
Hope this clarifies
Best wishes
i am a neurologist and thanks for posting this question in this web site
The causes of headache are so many and the approach to any patient with headache begins with a search for the exact cause of headache. The common causes of headache are migrain, tension headache, brain infection, tumor or problems in the blood vessels of the brain and so on.
Back to your question, the long duration of headache without any other symptoms (only you have posted headache, you have not told us which part of head, is there vomiting or other symptoms during headache or not) may suggest a possibility of migrain. How ever, one has to understand that migrain is a diagnosis of exclusion (the above cause need exclusion before we say that headache is due to migrain). If a CT scan rules out these possibility, the diagnosis of migrain will be confirmed.
Coming to the management of migrain, there are two aspects 1. To treat the acute and severe episodes- this can be treated with analgesics. other medicines which can be used are triptans provided that you donot have any cardiac problem.2. To terat the chronic phase or the medicines that can modify the headache-for this the options are sodium valproate, (this drug has a good evidence for this headache, but in females it may cause weight gain, menstrual irregularities), topiramate (it cause weight loos too, may be a good options if you are obese), amitryptiline, propranolol, atenolol etc. Apart from this one has to find out what triggers the headache like stress, food, perfumes , chocollate, coffee. These life style modificationa also help decrease the headache.
Hope this clarifies. If there is no recent change in the character of headache, you donot have to worry much. As your mum has hypertension alo, i think the medicine which can help will be atenolol or propranolol. She can start atenolol 50 mg for 7 days and increase to 100mg later. Make sure that she does not have asthma before giving this drug and you have to monitor her heart rate while being on this medicine.
Hope this clarifies
Best wishes
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