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Suggest Treatment For Severe Headaches
Question: I have severe headaches all the time, on the left side. I have type 2 diabetes, numbers running between 95 and 140. hypertension, polycythemia vera and had a stoke in my right eye. Currently have blurred vision, however eye doctor said eyes are fine. Although have hypertension, blood pressure has been controlled fine with the benazepril 115/75. Primary care doctor suggested a MRI asap. Wondering if I may have hemicrania continua ?
Take benazepril, metformin, atorvastatin, and 81mg aspirin. also feel a little nauseous
Take benazepril, metformin, atorvastatin, and 81mg aspirin. also feel a little nauseous
Brief Answer:
Hemicrania continua unlikely. Agree on necessity of imaging.
Detailed Answer:
I read your question carefully and I understand your concern.
Hemicrania continua among its criteria has some autonomic symptoms like injection of the conjuctiva, lacrimation, nasal congestion or discharge, small pupil, eyelid drop. You do not mention any such symptom. Furthermore a primary headache like hemicranias continua usually manifests much earlier in life, around the thirties. It's not totally impossible to appear at your age, but very unlikely.
I do agree with your doctor that a persistent unilateral headache requires brain imaging, even more so at your age, in order to search for causes like tumors, infections, stroke etc.
One other cause which I wonder if it has been considered by your primary care doctor is also temporal arteritis (otherwise called giant cell arteritis), an inflammation of the blood vessels. Its diagnosis is made not so much by imaging, rather by direct palpation of the temporal artery and a simple blood test for inflammation such as erythrocyte sedimentation rate.
Other causes like glaucoma I assume have been excluded by eye doctor. Sinusitis can at times be a possibility, imaging should detect that as well.
I remain at your disposal for other questions.
Hemicrania continua unlikely. Agree on necessity of imaging.
Detailed Answer:
I read your question carefully and I understand your concern.
Hemicrania continua among its criteria has some autonomic symptoms like injection of the conjuctiva, lacrimation, nasal congestion or discharge, small pupil, eyelid drop. You do not mention any such symptom. Furthermore a primary headache like hemicranias continua usually manifests much earlier in life, around the thirties. It's not totally impossible to appear at your age, but very unlikely.
I do agree with your doctor that a persistent unilateral headache requires brain imaging, even more so at your age, in order to search for causes like tumors, infections, stroke etc.
One other cause which I wonder if it has been considered by your primary care doctor is also temporal arteritis (otherwise called giant cell arteritis), an inflammation of the blood vessels. Its diagnosis is made not so much by imaging, rather by direct palpation of the temporal artery and a simple blood test for inflammation such as erythrocyte sedimentation rate.
Other causes like glaucoma I assume have been excluded by eye doctor. Sinusitis can at times be a possibility, imaging should detect that as well.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank-you, will keep you posted
Brief Answer:
You're welcome
Detailed Answer:
I hope everything works out for the best.
You're welcome
Detailed Answer:
I hope everything works out for the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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