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What Causes Acute Onset Of Severe Headache?

Posted on Mon, 2 Jun 2014

Question: Hi Doctor on early Saturday morning I was woken up by a sever headache bearly got up took 2 advils and went back to sleep after the headache got a little better.By mid day I felt more and more a stiff neck and very head heaviness feeling . Same thing on Sunday and today head does not hurt but still feel stiff and just like a head discomfort could this be a sight of brain aneurysm ? By the way I suffer from anxiety disorder

Answered by Dr. Anshul Varshney (2 hours later)

Brief Answer:
I need further details

Detailed Answer:
Dear Friend.
Welcome to HCM. I am Dr Anshul Varshney. I have read your query in detail. I understand your concern.

Any Acute onset severe headache should be investigated.
Headaches with Neck Stiffness are mostly due to:
1.Meningitis
2.Subdural Hematoma
3.Migraine

I would like to know a few more details.
1.Is this the first time you have suffered from such type of headache?
2.Headache is unilateral or bilateral?
3.Is your headache associated with any Double vision?
4.Any Vomiting/ Nausea/ Photophobia/Phonophobia?
5.Any Fever?
6.Any history of head trauma?
7.Any history of any drug intake?
8.Do you describe it as “Worst headache ever”?
9.Any history of any neurological deficit or weakness?
10.Any history of sinusitis/recurrent cough and cold?
11.Any history of hypertension?
12.Alcohol and Smoking status?
13. Any band like sensation on head?

This is my best advice for you based on available details. If you have any further query please ask me and revert with the asked details for a better help.
Stay Healthy.
Dr Anshul Varshney, MD

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

Follow up: Dr. Anshul Varshney (11 minutes later)

Not sure if I can say it's the worst headache of my life but it felt really bad ,as for everything else I don't drink no drugs , quit smoking about a year ago , not sure if I have sinusis even the the heavy head feeling goes from front were usually sines pressure is to. The back of the head and over the weekend I felt more worse when I wad out side , as for neurological issues it looks like I was told that I have an anxiety disorder so I get a lot of head pulsation my left arm hurts but it comes and goes . Just trying to figure it out if it was a headache or more serious there is no other complications no nausea or anything like that I get a little light headed when I look down just the neck is bothering me and very anxious can't sleep want to take lorazepam to come down but not sure if it's a Idea not to make thing even worse

Answered by Dr. Anshul Varshney (28 minutes later)

Brief Answer:
Get Investigated

Detailed Answer:
Dear Friend.
You have not answered my all questions.
However, In such conditions, following things are required:
1. Eye (Fundus) Examination to look for Papilloedema
2. MRI Brain.

I won't advise you take any sedative like Lorazepam. As it can worsen your status.
If the pain is severe, you might take Tramadol, till Neuroimaging is available.

In case you have Fever, you might require a CSF examination following Fundus examination and MRI Brain.

I am advising you for Neuroimaging because, your headache is Acute. And it should be evaluated for any underlying problem like Meningitis, Hydrocephalus and even Aneurysm.

Headache associated with Pulsations are usually not in Anxiety disorder, they usually occur in Migraine or Aneurysm.

So, get investigated and be sure.

If you have any further query, please ask me.

Stay Healthy.

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

Follow up: Dr. Anshul Varshney (9 minutes later)

I understand but i dont have a headache since saturday morning ,do you think i cantake tylenol for the neck stifness ? I dont have any other symptoms or head injuries that you asked just didnt like that headache its was very painful cant realy describe much of it because i was in deep sleep and dont think i ever had one that bad or at least dont rember, but let say it is aneurysm i would assume that it is not raptured because i would probably have other sypmthoms?

Answered by Dr. Anshul Varshney (27 minutes later)

Brief Answer:
Avoid Tylenol

Detailed Answer:
See, what is worrying me is your Neck Stiffness.
If it is an aneurysm and it bleeds, you would get Neck Stiffness.
If it is meningitis or Subdural Hematoma, you would get neck stiffness.

I am not saying that you have them, but it is always better to be sure.

I won't advise you to take Tylenol. As the safest pain killer is Tramadol.

Even if you don't remember well about your headache, and you were in deep sleep, that further warrants investigations that what made you go into deep sleep even with headache!

Get investigated to be sure.

Stay Healthy.

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