Hi and thanks for the query,
The symptom headache usually needs a careful clinical assessment. The age of the patient, past medical history, drug history, trauma history and any inherent medical conditions must be carefully considered. A psychosocial history is also carefully considered.

Headaches are generally primary (migraines, cluster headaches, tension headaches) or secondary ( due to infections, tumours, blood vessels problems, etc). These headaches present themselves differently.

Unilateral headaches, usually accompanied by nausea and vomiting, throbbing, around the menstrual periods in females, throbbing could be indicative of migraines. Cluster headaches generally affect the whole head, severe, accompanied by eye tearing and visual disorders and at times nasal discharge. Tension headaches will affect the head and the neck muscles most of the time.

Secondary headaches like tumours, abscesses or due to raised intracrabial pressure (excess cerebrospinal fluid) usually present with severe throbbing headaches, more intense in the morning, accompanied by visual disorders or intense pain when exposed to light. Signs like paralysis of a muscle group or a limb are common. Fever could be noticed in case of abscesses and nausea and early morning jet like vomiting.

A clinical evaluation is of utmost importance, taking into consideration all aspects of her social and medical history. Other examinations depending on the clinical orientation can then be asked such as the CT scan of the brain and an MRI.

I suggest she books an appointment with a neurologist for a proper clinical evaluation.

Best regards,
Luchuo, MD.

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