Thanks for posting this question in HCM
First of all let me tell you that a given medical problem can be due to various causes. Headache can be due to various causes too. It can be due to brain tumor
, infection, problem in the blood vessels of brain, migraine and so on. Whether a patient with headache will require a brain scan largely depend upon the presence or absence of neurological deficit on neurological assessment by a neurologist
. Further i will tell you that a patient with known migraine can have other problem which can cause headache too.
Back to our question, tunnel vision
can happen in migraine also. The only point of concern in postparum state is to rule out a possibility of cerebral venous sinus thrombosis
which can be done by doing a MRI scan with contrast venogram. Further MRI will guide us if you have other problem. If your MRI and MR Venogram both are normal you can follow the following to deal migraine. If it turns out to be anything else, you have to deal as per the doctor’s advice
Regarding the management of migraine there are two steps
1. Treatment of the severe episodes: During severe episodes, one can use paracetamol
, other analgesics, sumatriptan nasal spray
(make sure that you don’t have heart problem, it cannot be used if you have)
2. Treatment in absence of headache: There are medicines which can alter the migraine in due course and these medicines are to be used for daily for 6months-1 year. The medicines available are valproate (not good for females due to weight gain, menstrual problem,), topiramate, amitriptiline, propranolol.
3. Identify the factor which aggravates the headache and try to avoid coffee and strees, sleep deprivation
. Do relaxation. All these methods will decrease the severity of headache and prevent future episodes.
Hope this will clarify