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What Causes Headache, Stiffness And Soreness In Neck And Elevated Heart Rate?
Question: My 24 year old son has had a headache since Saturday that has not bee relieved by any medication. in addition to the headache, he has a stiff and sore neck, elevated heart rate, increased blood pressure for him, states his eyes are sensitive to light which is not normal either. He also had some back pain and abdominal discomfort on Saturday and Sunday, but is much better now. No radiating pain anywhere. We went to the ER, and all blood work CBC, liver enzymes, were normal. His urine contained a lot of red blood cells, they did a CT and said there was not any kidney stones, but he did have mild spleen enlargement. They determined he had dehydration because he was out in the sun and heat a lot over the weekend, but he stated he had been staying hydrated. He received a liter of IV fluid, and continues to drink when he is awake. Besides dehydration, what could be the cause of these symptoms? I was concerned initially it might be meningitis, or mono. He has a very physically demanding job in a manufacturing plant that makes automobiles. Any other ideas of what may be causing these symptoms?
Brief Answer:
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Detailed Answer:
I read your question carefully and I understand your concern.
Those symptoms are indeed a little worrying. I am not sure I would've been so easily content with the dehydration hypothesis as the ER doctors. Not that I exclude it but there are other possibilities to consider, especially now since he's not been getting better.
In front of headache, with stiff neck, light sensitivity, two conditions which need to be excluded would be subarachnoid hemorrhage and meningitis which you mentioned. The fact the CBC is normal and you do not mention fever, makes meningitis less likely. However the subarachnoid hemorrhage possibility remains. For that reason I think some type of brain imaging (CT or MRI) as well as a lumbar puncture are recommended, to look for blood products.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Those symptoms are indeed a little worrying. I am not sure I would've been so easily content with the dehydration hypothesis as the ER doctors. Not that I exclude it but there are other possibilities to consider, especially now since he's not been getting better.
In front of headache, with stiff neck, light sensitivity, two conditions which need to be excluded would be subarachnoid hemorrhage and meningitis which you mentioned. The fact the CBC is normal and you do not mention fever, makes meningitis less likely. However the subarachnoid hemorrhage possibility remains. For that reason I think some type of brain imaging (CT or MRI) as well as a lumbar puncture are recommended, to look for blood products.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your feedback. We are going to follow up with his doctor on this. If he gets worse before we can get to the doctor, we will go straight to the ER again, and question them for more possibilities and more testing to see where the problem is originating from. He did not have a fever at all. I am concerned about the possible hemorrhage. He does not recall any type of injury to to his head or neck. Is it possible to have a subarachnoid hemorrhage without an injury? If so what could cause that? He does not take any medications on a regular basis. Periodically he will take something for a headache or sinus congestion. But none of that lately. He does not smoke, and drinks alcohol socially only. He does not do any illegal drugs as he is always subject to random drug testing through his work and through the Army Reserves.
Brief Answer:
Read below.
Detailed Answer:
Thank you for the update.
The fact he hasn't had any injury doesn't help much in excluding subarachnoid hemorrhage. It can happen in the absence of a trauma, due to the rupture of a blood vessel malformation. I do not want to alarm you though, I am sure it is a diagnosis which has passed in the ER doctor's mind and I suppose he/she hasn't considered likely from the history taking and physical exam.
However I still maintain that since it's 4 days now, in someone previously healthy, without anything pointing to causes such as sinusitis, viral infections, migraine etc, some type of brain imaging is recommended to exclude subarachnoid hemorrhage or other types of stroke.
I hope he will get better
Read below.
Detailed Answer:
Thank you for the update.
The fact he hasn't had any injury doesn't help much in excluding subarachnoid hemorrhage. It can happen in the absence of a trauma, due to the rupture of a blood vessel malformation. I do not want to alarm you though, I am sure it is a diagnosis which has passed in the ER doctor's mind and I suppose he/she hasn't considered likely from the history taking and physical exam.
However I still maintain that since it's 4 days now, in someone previously healthy, without anything pointing to causes such as sinusitis, viral infections, migraine etc, some type of brain imaging is recommended to exclude subarachnoid hemorrhage or other types of stroke.
I hope he will get better
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. You have been very helpful. I am so glad I found this site. I hope he gets better too, and sooner rather than later. Have a great evening!
Brief Answer:
Thank you.
Detailed Answer:
Thank you.
Thank you.
Detailed Answer:
Thank you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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