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Suggest Remedy For Pain On Left Side Of Head Behind The Ear

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Posted on Mon, 14 Sep 2015
Question: Two days ago I was talking to a passenger in the right hand seat on the train for nearly three hours and suddenly had a severe stabbing pain on the left hand side of my head behind my ear. For the rest of the day it occurred at fairly frequent intervals.. Three weeks ago I had cataract surgery on my left eye. Since then it has gone. I am 75, very fit and slim. I take 2mg candesartan each day, and an aspirin. I worry about strokes as my father had carotid stenosis and died. I had a private imaging a few years ago that said I had mild carotid stenosis on the left side, but my doctor said that I shouldn't worry about it as there was nothing anyone could do. My husband thinks I should go to the doctor but I don't want to bother her if it is only a transient thing and not a sign of a brain tumour or imminent stroke! I should be glad of your advice please.
doctor
Answered by Dr. Olsi Taka (39 minutes later)
Brief Answer:
Does not look alarming

Detailed Answer:
I read your question carefully and I understand your concern.

Looking at that description of stabbing pain, coming and going, which now has subsided I do not think that a tumor or stroke is likely. A brain tumor has not such a sudden severe onset. Also the pain would not spontaneously resolve, in a brain tumor it would be more persistent and would grow progressively. In stroke it can improve but only over the course of the following days, not evaporate in less than 24 hours.

The pain looks more typical for a peripheral nerve pain. At that location occipital nerve irritation could be a possible explanation. Upper cervical spine arthritis may affect that nerve or cause muscle spasms in the area, perhaps standing with the head turned for a prolonged period may have been the trigger.

Your doctor is right about mild carotid stenosis, only aspirin is needed only in severe cases surgery or stenting is considered. Not related to current symptom though, a stroke in the territory covered by the carotid doesn't have that pain type and location.

So for now since you have no other symptoms I wouldn't advise hurrying to the doctor, only observation for new symptoms.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (1 hour later)
Dear Dr.Olsi Taka,

Thanks so much. I feel fine about it now, and I am glad to know about symptoms. After I had written to you I remembered that I had forgotten to mention that I get very dizzy if I put my head back for any reason - hair dressers, looking up our boat’s mast, turning my head to the left when in bed. That has been going on for ages and I was told to take Stugeron as it was probably a middle ear infection. It was just that with the dizziness combined with the pain and stenosis, I had jumped to the wrong conclusions. Anyway… Panic over!

It seems a great idea being able to write to someone about a worry.

Regards,

Val Gillespie
doctor
Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below.

Detailed Answer:
Thank you for that additional information and the appreciative words.

More than a middle ear infection those signs would correlate with neck arthritis in my opinion. It could cause such dizziness through two possible mechanisms.

The first, the most common, would be compression of upper cervical nerves. These nerves are involved in balance as they provide the brain information on head and neck movements and position, so their involvement might cause those symptoms.

Another less common mechanism is when they compress the vertebral arteries, arteries supplying with blood the posterior part of the brain. These arteries pass through the vertebral structures, so advanced arthritis changes may compress and narrow them and actions like raising the head might temporarily increase this narrowing with as a result transitory lack of blood supply to posterior brain areas, hence the symptoms. If this was the case it increases the risk for stroke I'm afraid, anyway aspirin is the best means of lowering that risk. The first mechanism is more probable though, I wouldn't want you to worry. But a repeat of that neck vessel imaging exam would be advised.

Wishing you good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (2 hours later)
Dear Dr. Oisi Taka,

I had not meant you to reply about the dizziness as I thought it was just my ears.
Anyway I was very pleased to have your opinion, and have printed out the whole discussion and will take it to my doctor, who may be able to refer me for imaging.

Thanks so much for your help.

Regards, Val Gillespie
doctor
Answered by Dr. Olsi Taka (5 minutes later)
Brief Answer:
You're welcome.

Detailed Answer:
I had realized the information was not meant as a question, but seeing as it could relate with your initial question I wanted to let you know that.

Thanks again for coming at HealthcareMagic.

Best regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Suggest Remedy For Pain On Left Side Of Head Behind The Ear

Brief Answer: Does not look alarming Detailed Answer: I read your question carefully and I understand your concern. Looking at that description of stabbing pain, coming and going, which now has subsided I do not think that a tumor or stroke is likely. A brain tumor has not such a sudden severe onset. Also the pain would not spontaneously resolve, in a brain tumor it would be more persistent and would grow progressively. In stroke it can improve but only over the course of the following days, not evaporate in less than 24 hours. The pain looks more typical for a peripheral nerve pain. At that location occipital nerve irritation could be a possible explanation. Upper cervical spine arthritis may affect that nerve or cause muscle spasms in the area, perhaps standing with the head turned for a prolonged period may have been the trigger. Your doctor is right about mild carotid stenosis, only aspirin is needed only in severe cases surgery or stenting is considered. Not related to current symptom though, a stroke in the territory covered by the carotid doesn't have that pain type and location. So for now since you have no other symptoms I wouldn't advise hurrying to the doctor, only observation for new symptoms. I hope to have been of help.