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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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I am experiencing short, repeating headaches on the front left

Answered by
Dr. Dariush Saghafi


Practicing since :1988

Answered : 2429 Questions

Posted on Wed, 6 Feb 2019 in Headache and Migraines
Question: I am experiencing short, repeating headaches on the front left side of my head with some additional pain in the nasal area on the same side.
Answered by Dr. Dariush Saghafi 1 hour later
Brief Answer:
Possible hemicrania type

Detailed Answer:
Good evening. I am sorry you are having these problems. The description of your headaches is rather lean to make an accurate diagnosis but I am happy to speak in generalities. First and foremost, if headaches are not considered COMMONPLACE for you and these headaches are absolutely brand new nature then, one must seriously being seen in an emergency room or doctor's office sooner rather than later. In other words, in a 54 year old woman severe headaches typically don't just start to happen one way without a cause. Therefore, if these headaches are absolutely something you've never ever experienced in your life then, you must rule out the presence of something within the skull that could be causing them. I would get to a neurologist ASAP under these assumptions (or a Headache Specialist...such as myself) and request that an imaging study of the brain be performed (if the doctor does not offer it to you first).

If on the other hand these are not terribly new.....then, other headache types that could be at play would be PAROXYSMAL HEMICRANIA. These headaches typically last a duration of 2-20 min. and can be rather severe and draining on a person.

Pain in the nasal area with the headaches is not surprising and does not necessarily represent a sinus infection or such thing. But rather, it is part of this clinical picture we call TRIGEMINAL AUTONOMIC CEPHALGIA.

Of course, the rule of thumb in headache medicine is ALWAYS, ALWAYS, ALWAYS rule out other specific types of pathologies that could be causing these complaints before settling on the diagnosis of some form of HEADACHE DISORDER. My recommendation is that you connect with either a neurologist or preferably a HEADACHE SPECIALIST.

If it is decided that these headaches fulfill the criteria for either a TRIGEMINAL AUTONOMIC CEPHALGIA or even TRIGEMINAL NEURALGIA THEN, a trial of INDOMETHACIN seems indicated and warranted. I would recommend starting at 25 mg. daily and depending upon symptoms could try a Medrol Dose back of either 14-21 days. I would then, consider ESCALATING the indomethacin to both twice daily and then, thrice if necessary.

I'm tempted to throw out a diagnosis of CLUSTER HEADACHE, but here are a couple of reasons why I am not happy with that diagnosis. First, the headaches in cluster are usually described by an excruciating pain that bores or stabs in the area of 1 wife. Secondly, clusters tend NOT TO LOCATE themselves in the forehead of an individual but rather set up shop in the ocular ORBIT and are one of the most EXCRUCIATING HEADACHE PAINS known to mankind.... There are other criteria as well....but this should get you started.

If I've provided useful information could you do me the favor of CLOSING THIS QUERY with a 5 STAR rating and positive feedback?

Please note that I've spent 29 minutes total time spent reviewing, researching, and analyzing the present query.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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