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Suggest treatment for severe headache in a hypertensive person

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Posted on Sat, 14 May 2016
Question: my husband just came home with a blinding headache -- so bad he threw up. He said that right before the headache hit, his vision got really bizarre. This is not a common occurrence. I just took his blood pressure and it is 113/55. Does he need to go to ER?
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
I believe he does need to go to ER

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

Given your description of very intense pain, of an abrupt onset, with no prior occurrences I would say that attention is needed and a visit to ER is advisable.

Hopefully it will turn out in the end to be just a migraine with visual aura, but given that 54 is an uncommon age to have ones first migraine attack and given the fact the pain was so abrupt I believe he should be evaluated for the possibility of a subarachnoid hemorrhage. For that apart from the careful history taking checking for signs of meningeal irritation is necessary like neck rigidity. However when description of very sudden, very intense pain, of an intensity never experienced before it is advised even when there are no signs to have a CT scan.

Let me know if I can further assist you.
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 : 3669 Questions

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Suggest treatment for severe headache in a hypertensive person

Brief Answer: I believe he does need to go to ER Detailed Answer: I read your question carefully and I understand your concern. Given your description of very intense pain, of an abrupt onset, with no prior occurrences I would say that attention is needed and a visit to ER is advisable. Hopefully it will turn out in the end to be just a migraine with visual aura, but given that 54 is an uncommon age to have ones first migraine attack and given the fact the pain was so abrupt I believe he should be evaluated for the possibility of a subarachnoid hemorrhage. For that apart from the careful history taking checking for signs of meningeal irritation is necessary like neck rigidity. However when description of very sudden, very intense pain, of an intensity never experienced before it is advised even when there are no signs to have a CT scan. Let me know if I can further assist you.