I'm sorry to hear about your headache.
The management of your headache depends on what is causing the headache. Any underlying cause of a headache needs to be determined unless the workup has already been done.
Signs that require medical evaluation are: New headaches
, a headache that has changed in quality and doesn't feel like your past headaches, headaches that come on suddenly and cause severe pain
, headaches causing any focal neurological symptoms.
In your cause, if you hadn't had an evaluation done, you definitely need one. Although losing vision could be something as simple as a migraine
, it could be something more serious as well.
Morning headaches can be seen in obstructive sleep apnea
, although typically they are not as severe as you are describing. Another cause can be increased pressure surrounding the brain. When you lie down, the pressure increases inside the head, and if it is already high it can cause worsening pain. As you sleep in bed, the higher pressure exerts pressure on the brain and its lining causing increasing pain. Increase pressure can also affect the optic nerves causing visual changes.
There are multiple causes for increase pressure inside the head and the treatment depends entirely on what is causing it. It can result from an idiopathic cause (no known cause) - this is called idiopathic intracranial hypertension
, it can also result from obstructive hydrocephalus
in which the flow of cerebrospinal fluid
is block or the absorption is blocked. There are also multiple reasons for this, but the most common reason is a growth of some kind which can be both benign or malignant.
Changes in blood flow in the brain can result in headaches as well, clots in the vascular system in the brain, particular the venous system, can cause increasing pain and pressure as well.
The bottom line is that you need to have a medical evaluation and an MRI of your brain, preferably with contrast and without. If you cannot get an MRI then a CT is the bare minimum, but an MRI would be preferred. All dangerous causes need to be excluded before presuming more benign changes.
The point of this answer is not to alarm you, again this could be something as simple as a migraine or sleep apnea, but this is how we think as physicians and it is extremely important not to miss anything.
You can continue to take the nurofen for the pain for now, in moderation.
I hope this helps
Kristoffer Nissinen, M.D.