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Dr. Andrew Rynne

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What causes persistent headaches?

Answered by
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Dr. Prasad

General & Family Physician

Practicing since :2005

Answered : 2649 Questions

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Posted on Mon, 4 Aug 2014 in Headache and Migraines
Question: For the past few years I live with a terrible headache. And I always have 37-37.1 C fever which sometimes is the reason of a headache. But not always. Other reasons may include sometimes high blood pressure or something other which could not be understood. I've made all possible surveys, but nothing serious was found. But the headache continues. So I'm in despair. I tried lots of things. And sometimes some of them helped. But not for a long time. And it is really hard to live with.
I have some little problems with my health like gastritis or other, but they not seem to be the reason of a headache as I lived with them for many years.
doctor
Answered by Dr. Prasad 6 hours later
Brief Answer:
Can you describe the headaches?

Detailed Answer:
Hi,

From what I understand you are suffering with a chronic headache. You have found some factors that are associated with headache. However those factor are not sufficient to arrive at possible causes. Can you describe the headache?
I am particularly interested to know
- how severe the pain is?
- Is it unilateral or bilateral ache?
- Do you feel the pain as throbbing / aching?
- Do you feel nauseated / vomit when you have those aches?
- How long does a typical headache last?
- Does sound and light worsen headache?
- If there are any other associated symptoms during an attack?
- How frequently do you get this ache in a calender month?
- Besides gastritis, what other medical conditions do you have?
- Was a brain scan performed? - if yes, was it normal?
- Lastly can you list the drugs / treatment that helped you.

I look forward to these details which will allow me to have an useful discussion.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 5 days later
Dear Dr XXXXXXX

Please find the answers below:

> - how severe the pain is?

The pain is really powerful. And often it is accompanied with nausea and dizziness. But not always. When it begins I feel completely exhausted for seconds. And the only thing that helps is peace. I lay down on bed. And after some time I feel better. When I lie the pain is not as strong.

> - Is it unilateral or bilateral ache?

Sometimes it is localized in one point. In center of forehead. But often it's entire forehead and neck at the same time.

> - Do you feel the pain as throbbing / aching?

Sometimes it is throbbing but not always.

> - Do you feel nauseated / vomit when you have those aches?

Sometimes I feel nauseated and vomit indeed.

> - How long does a typical headache last?

If it begins, it lasts the whole day.

> - Does sound and light worsen headache?

The sound affects mostly. Loud.

> - If there are any other associated symptoms during an attack?

Sometimes it is accompanied with loss of balance. Feels like something throws me from side to side. And feeling of exhaustion. Sometimes it feels like I can't breathe. Like it is lack of air. Hard to take a breath.

Sometimes also it is accompanied by high blood pressure.

> - How frequently do you get this ache in a calender month?

Nearly every day. Sometimes every other day or every two days.

> - Besides gastritis, what other medical conditions do you have?

I have also chronic tonsillitis and scoliosis (left-side).

> - Was a brain scan performed? - if yes, was it normal?

Yes, brain scan was performed. And the results were good. I've also made chest and spine MRI. And the results were also good.

> - Lastly can you list the drugs / treatment that helped you.

Yes. Ibuprofen, Spazmalgon and intramuscular injection of tripharmacon which is:nospanum (or papaverine), analgene and diphenhydramine. Massage helps.

Vladimir.
doctor
Answered by Dr. Prasad 7 hours later
Brief Answer:
You need to try prophylactic medications.

Detailed Answer:
Thanks for providing the needed details. Based on these details, I feel the headaches are a type of chronic headaches. They tend towards symptoms of migraine but not truly classical migraine. The fact that brain scans are normal, it rules out serious causes of such recurrent severe episode headaches.

Temperature of 37 and 37.1 deg C is normal. So I do not suspect infective pathology. So that's another positive sign.

In this context, I would order a complete hemogram and ESR. If these tests are also normal, I would start you prophlactic medications. Unlike the ones you been on, these prophylactic drugs are not pain killers; they are every day medicines that lower and desensitizes you to pain. Tricyclic antidepressant class of medications, calcium channel blockers, beta blockers, tryptamine based drugs are some examples of prophylactic medications. Your local doctor/neurologist will know about them.

Well, gastritis is definitely not the sole reason for such headaches. But in many patients with such chronic headaches, there seems to be some link between the two. You should get that sorted too.

Hope this information suffices. Let me know if you need clarifications.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prasad 3 hours later
Dear Dr XXXXXXX

Here's an important remark from another person that I know:

=============
The temperature is measured under the armpit (standard for Russia) and the normal temperature there is 36.5-36.6.

37.0-37.1 is usually considered a mild fever - and would normally correspond to an oral measurement of 37.6
=============

If a person would have a mild fever and the above symptoms, what would you recommend?
doctor
Answered by Dr. Prasad 21 hours later
Brief Answer:
My plan of action remains the same...

Detailed Answer:
Hi,

I didn't know temperature is recorded by checking armpit temperature. However since you said fever is not the lone cause of headache and that there are other factors, I will stick to my previous answer.

Chronic headaches such as migraine have triggering factors. Acute infections, increased stress, lack of sleep, fasting, sun exposure are some of the common trigger factors. Increased blood pressure can also make headache worse.

In other words, fever and all other factors that you mentioned are associated condition affecting chronic headache. Management is as mentioned earlier - prophylactic medicines.

Hope you are convinced now. I'll be glad to explain further in case you need clarification.

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