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What Causes Right-sided Headache When Diagnosed With Viral Meningitis And Intracranial Hypertension?

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Posted on Mon, 4 Jan 2016
Question: Hello. I Have had a right sided headache for 4 weeks now. It is like a sharp pain right on the top of the right of my head, stabbing pain in the right temple, and pain in front of the ear on the right and also slightly into the jaw. Headache at the back of my head like a pressure headache and also feels like pressure across my forehead. I was first diagnosed with viral meningitis and intracranial hypertension, with an opening pressure of 25 and blurred margins in my eyes. After treatment I went home with a weeks worth of acetazolamide. After 2 weeks I still had the headache and it had become slightly worse so I went back to the hospital and was told the pressure had gone back up. They did another lumbar puncture and removed enough fluid to get the pressure down to 16. I went home the next day and the headache started to get worse again. I was then diagnosed with a post lumbar headache, even though it was the same pain as from before, and told to drink lots of fluid and bed rest for 2 weeks. This I did and the pain finally started to ease off at the end of the second week. That weekend I started moving around as normal, on the sunday I had a hot bath. About ten minutes later the pain came on so intense that I was crying. I have been back to the hospital and the doctor over the past 3 days and have been told it is a migraine, a cluster headache, and now today it is musculature pain. I also have pain down my neck, on the right side, which has been there all along. I have also been getting palpitations and high blood pressure of 170 over 97 and high pulse of 150 when I move about, but that has just been ignored. My right arm feels heavy. My hearing in my right ear keeps going and coming back, and I have been having problems with my vision as things I look at flash up for a split second looking larger than they are. I also have some tingling on the right side of my face and my ear. All this came on suddenly after an incident where I injured my neck slightly by turning round to look up awkwardly, and crooked my neck and felt a weird warm sensation spread up my neck and bottom of my head. Is it really musculature pain? I am taking 10mg buprenorphine, naproxen 500, amitriptyline 30mg, paracetamol regularly. I have also tried aspirin but have been advised not to take naproxen at the same time. I would really like another opinion on this as I am dizzy and feel very odd, like I keep feeling de ja vu and my senses feel different. I also keep feeling my hair stand up on end all the time on my head. I have had a ct scan with angiogram, and an mri scan, but I do not yet know the results of the mri and have an appointment scheduled with the neurologist for 8 weeks time, but I am in so much pain I can't even bear to think of this carrying on for much longer. Also the reason they diagnosed meningitis at first was because my inflammatory markers were up and I had a fever of 103 degrees, but that was only on the first day and it's never returned. Please help.
doctor
Answered by Dr. Ajay Panwar (50 minutes later)
Brief Answer:
Please upload documents/CSF report

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I completely understand your concern and shall try to address it at my best.

The dilemma over here is that whether the headache is 'Primary headache' or 'secondary headache'?
As,you have been diagnosed with raised intracranial pressure,so it gets really tricky to solve the issue.However,the best way to diagnose is - observing the response after therapeutic(large volume) CSF drainage.If this headache is due to raised intracranial pressure,it should ease off with the removal of large volume CSF.However,if the main component is of primary headache(like migraine),then it should not improve much with therapeutic lumbar puncture.

Another point to stress over here is that - even high blood pressure can cause headache.So,It should be observed whether headache improves after BP control is achieved well.This can be just another contributing factor.

For now,
I would suggest you to please upload the CSF reports and other medical documents you have, as scanned .jpg images.I would appreciate if you can upload the brain scan reports.

Please follow up with details.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
Dr.
Dr. Ajay Panwar

Neurologist

Practicing since :2007

Answered : 1827 Questions

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What Causes Right-sided Headache When Diagnosed With Viral Meningitis And Intracranial Hypertension?

Brief Answer: Please upload documents/CSF report Detailed Answer: Hi XXXX, Thanks for being on healthcaremagic.com. I am Dr.Ajay Panwar,a neurologist,here to answer your query. I completely understand your concern and shall try to address it at my best. The dilemma over here is that whether the headache is 'Primary headache' or 'secondary headache'? As,you have been diagnosed with raised intracranial pressure,so it gets really tricky to solve the issue.However,the best way to diagnose is - observing the response after therapeutic(large volume) CSF drainage.If this headache is due to raised intracranial pressure,it should ease off with the removal of large volume CSF.However,if the main component is of primary headache(like migraine),then it should not improve much with therapeutic lumbar puncture. Another point to stress over here is that - even high blood pressure can cause headache.So,It should be observed whether headache improves after BP control is achieved well.This can be just another contributing factor. For now, I would suggest you to please upload the CSF reports and other medical documents you have, as scanned .jpg images.I would appreciate if you can upload the brain scan reports. Please follow up with details. Regards Dr.Ajay Panwar, MD,DM(Neurology)