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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Remedy For Headache And Vertigo

I had a fall 7/2015 hitting the left side of my head (upper cheek area). Since the fall I ve been experiencing headaches/migraines, N/V, vertigo in various degrees of disturbances and gait disturbance. None of these appeared until after my fall. The MRI did show ischemia in the pons region. Your input please.
Wed, 25 Jan 2017
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Neurologist, Surgical 's  Response
Hi, thanks a lot for asking from HCM.

I can understand your concern. The ischemia in pons area is the most probable cause of vertigo, gait disturbances and inco-ordination.

Regarding post traumatic headache/migraine and nausea/vomiting, it can occur for 1-2 years after significant head injury. If at that time, you had any fracture or intracranial bleed, then this headache is post-traumatic. Otherwise, it must be classical migraine.

For treatment of migraine, you can take following treatment

- Preventive therapy - It is taken to delay the episodes of pain attacks. You can take any of the following drugs
Propranolol or Amitriptyline or Gabapentine or Pregabaline. You can take medication only after proper prescription.

- Abortive therapy - It is taken to treat pain attack. You can take any of the following drugs
NSAIDs (Diclofenac/Ibuprofen) or Sumatriptan or Ergotamine.
You can take medication only after proper prescription.

For vertigo, you can take
- Tablet betahistine or combination of betahistine/Cinnarizine/Ginkgo biloba after proper prescription.

As you have pontine ischemia, you must consult neurologist to control the disease. He will start you on anti platelets like tablet aspirin and clopidogrel to prevent any further episode. Investigations like CT angiography of neck and brain vessels is needed to know about diseased vessels. Please don't ignore it.

Hope it will help you. If you need more help, do let me know.
Thanks
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Suggest Remedy For Headache And Vertigo

Hi, thanks a lot for asking from HCM. I can understand your concern. The ischemia in pons area is the most probable cause of vertigo, gait disturbances and inco-ordination. Regarding post traumatic headache/migraine and nausea/vomiting, it can occur for 1-2 years after significant head injury. If at that time, you had any fracture or intracranial bleed, then this headache is post-traumatic. Otherwise, it must be classical migraine. For treatment of migraine, you can take following treatment - Preventive therapy - It is taken to delay the episodes of pain attacks. You can take any of the following drugs Propranolol or Amitriptyline or Gabapentine or Pregabaline. You can take medication only after proper prescription. - Abortive therapy - It is taken to treat pain attack. You can take any of the following drugs NSAIDs (Diclofenac/Ibuprofen) or Sumatriptan or Ergotamine. You can take medication only after proper prescription. For vertigo, you can take - Tablet betahistine or combination of betahistine/Cinnarizine/Ginkgo biloba after proper prescription. As you have pontine ischemia, you must consult neurologist to control the disease. He will start you on anti platelets like tablet aspirin and clopidogrel to prevent any further episode. Investigations like CT angiography of neck and brain vessels is needed to know about diseased vessels. Please don t ignore it. Hope it will help you. If you need more help, do let me know. Thanks