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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for addison s disease and headache

Hi. Am a renal transplant patient with addison s disease, angina and on steroids for 30 years. Have had an ongoing UTI infections which ecoli but a strain anti resistant so far to all antibiotics. The doctor and hospital are trying to address this. I collapsed three weeks ago at the railways station, passing out before I hit the marble floor and cracked the left hand side of my head. BP very low due to the addison s. I had concussion and was admitted to hospital where intravenous fluids, hydrocortisone and antibiotics were administered. Skull xray had a suspect slight fracture, however due to the swelling and how black and blue I was it was apparently difficult to give a definitive on that. A follow up x ray has not been conducted but I have had ongoing headaches on the opposite side of my head and sometimes intense pain which flutcuates and then calms down. Should I return to my doctor and request a further xray or is that normal? Thank you for your time. kind regards, M.
Tue, 1 Oct 2019
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Question is related to
Diseases and Conditions ,  
Drug/Medication
Endocrinologist 's  Response
Hello,

Addison's disease causes a shortage of cortisol, which is a hormone responsible for helping the body cope with stress.

Physical stress, such as an injury, infection or emotional stress can worsen the condition of a person with Addison's disease since their bodies lack the natural stress response hormones.

You have a renal transplant, angine, and a recent UTI infection and al these stressful events had caused an Addisonian crisis. So you had a collapse with hypotension and consecutive brain trauma.

Headache is one of the most common symptoms after traumatic brain injury, often called “post-traumatic headache”.

You have a headache because you may have small collections of blood or fluid inside the skull or because of the changes in the brain caused by the injury, neck and skull injuries that have not yet fully healed (like your skull fracture for ex).

In the first few days after a head injury, it is necessary to do a CT scan of your brain to make sure there is no bleeding in your head.

So, to answer to your question: If you were my patuient I will ask to do a CT scan of your brain (apart from the skull X-ray, to clarify if you have possible complications caused by recent head trauma.

Remember to increase the doses of Hydrocortisone every time you have physical or psychological stress, in the future to prevent hypotension and a potential Addisonian crisis.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Elona Xhardo, Endocrinologist
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