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Suffering From Headache. CAT Scan, MRI Of Neck And Head Fine. Why Am I Getting Headache?

Posted on Tue, 9 Oct 2012

Question: HI I HAVE BEEN SUFFERING HEADACHES FOR A NUMBER OF YEARS. THEY HAVE WORSENED OVER THE LAST 18MTHS I GET THEM EVERY SINGLE DAY, THEY ARE WORSE WITH MOVEMENT. I HAVE HAD A CAT SCAN OF MY HEAD AND MRI OF MY NECK AND HEAD. BUT THE DOCTOR SAID THEY ARE FINE

Answered by Dr. Sudhir (59 minutes later)

Hello,

Thanks for questions.

Since CT and MRI are normal, possibility of migraine seems more likely. Migraine headaches are know to be chronic and may not respond well to OTC analgesics.Medications to treat migraine headaches are either abortive or prophylactics.

During the onset of a headache, some people respond to inhalation of 100% oxygen.Alternative first-line treatment is subcutaneous administration of sumatriptan.

Lidocaine and other topical anesthetics sprayed into the nasal cavity may relieve or stop the pain, normally in a few minutes, but long term use is not suggested due to the side effects and possible damage to the nasal cavities.

Ergot compounds like cafergot have also been effectively used.

Other abortive remedies that work for some include ice, hot showers, cool or lukewarmwater sprayed on the face around the sinus, temple, and ear areas, breathing cold air, application of analgesic balm beneath the nostrils, caffeine, and drinking large amounts of water in the early stages of an attack. Vigorous exercise has been shown in some cases to be very effective in relieving and aborting an acute attack by increasing the levels of oxygen within the body.

Avoid triggers like deprivation of sleep, smoking , alcohol ,bright light , inhalation of strong chemicals etc.

Prophylactic treatment include calcium channel blocker (verapamil),Steroids(prednisolone) ,magnesium sulfate.

Normally with some trial and error both doctor and patient reach most effective treatment in a particular case .

I think you need to consider possibility of migraine or reconsider it (if already considered in past) with other treatment options.

Please ask if there are doubts.Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir (1 hour later)

IM SORRY I DONT THINK I GAVE YOU ENOUGH INFORMATION. I ALSO HAVE SCOLIOSIS, AND I DO GET NECK PAIN. EVERYONE KEEPS SAYING MIGRAINES BUT WHEN I LOOK UP MIGRAINE SYMPTOMS, THATS NOT THE TYPE OF HEADACHE THAT I GET. I HAVE BEEN GOING TO DOCTORS OVER THE CAUSE OF MY LIFE AND NOT ONE OF THEM CAN TELL ME WHAT THE PROBLEM IS, AND DONT SEEM TO BE ABLE TO HELP ME AT ALL. MY MRI OF MY NECK THE IMPRESSION WAS MODERATE C5/6 CHANGES WITH A MILD/MODERATE RIGHT FORAMINAL STENOSIS. COULD THIS CONTRIBUTE TO MY HEADACHES. X-RAY CERVICAL SPINE; MILD UPPER THORACIC CURVATURE CONCAVE TO THE RIGHT NOTED.

Answered by Dr. Sudhir (10 hours later)

Can you please describe nature of headache? Do you get any symptoms prior to onset of headache? Are there any triggers which precipitate headaches? Was color doppler done for neck blood vessels? Do you suffer from any other medical condition?

Please provide these details.Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir (6 hours later)

I USUALLY GO TO BED WITH A HEADACHE AND MAJORITY OF THE TIME I WAKE UP WITH ONE. I TRY AND DO EVERY DAY THINGS AND MY HEADACHE JUST SEEMS TO GET WORSE, I AM UNABLE TO WORK AT THE MOMENT. OTHER THAN MOVEMENT I CANNOT SEEM TO PINPOINT A TRIGGER AS SUCH. NO I HAVE NOT HAD COLOR DOPPLER DONE DO YOU SUGGEST THIS TEST . I AM FEELING PRETTY DESPARATE AS I AM NOT ABLE TO FUNCTION IAM NOT ABLE TO EVERYDAY THINGS. I TRY TO SAY WASH THE THE DISHES, MY HEADACHE GETS WORSE AND I HAVE TO GO LIE DOWN. DOCTORS ARE TRYING TO TELL ME ITS EMOTIONAL, I KNOW MY OWN BODY AND I FEEL THIS IS PHYSICAL. THE PHYSIO IM SEEING AT THE MOMENT TELLS ME ITS PHYSICAL, BUT SHE IS TREATING THE SYMPTOMS, NOT ACTUALLY THE PROBLEM. I NEED SOME ANSWERS HELP!!!!!!!! XXXXXXX.

Answered by Dr. Sudhir (5 hours later)

Thanks for the detail.

Headache which is there even after sleep and which worsens as day progresses is likely to be tension type headache.May be in addition to this you might be having strained neck muscles, when headache is at it's peak.

(Actually few years back I had similar episodes, treated earlier as migraine and evaluated with MRI.But none of the treatments helped.Finally we decided to try treatment for tension type headache and it helped)

I would recommend a consultation with neurologist and discuss this possibility.A trail treatment of two weeks can be undertaken.

In view of details I am pretty sure of the diagnosis, but I would suggest to get it confirmed by a neurologist.

Please ask if there are doubts.Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar