Headache-Adviser.com

New Headache On Top Of Head

by Cristina O
(Lincolnwood, IL)

Two months ago, at 41 yo, I started having HA on the top of the head. I never had HAs before. Initially, there was difficulty with bright light and looking up. I also had a sensation of compression on the right side of my esophagus.

I went to ER after 7 days of HA and the MRI showed at least 2 small nodules in the parenchema of the lateral ventricles that did not inhance. The MD said that they are probably benign and not the cause of my HA.

Since than the HA are back especially at night and I started having nausea about 2 nights ago. I also have 2 small thyroid nodules and hypothyroid symptoms (fatigue, loss of hair, hypotensive). I am also suspecting gallblader/liver but never had any symptoms before.



I will see a neurologist and endocrinologist next. Please help with any suggestions.

Answer:

Hi Christina,

It sounds like the symptoms initially were suspicious for an atypical migraine. Tightness in the throat is common in anxiety which is heightened during a migraine..especially if you have never had anything like this before.

Other types of headaches may be causing the problem, such as tension headache. Try over the counter Aleve, until you can see the neurologist.

You mention the thyroid. Hypothyroidism is one of those medical conditions that can make headaches worse. The correction of the thyroid will help with the headaches.

When you see the neurologist, be sure to take a copy of the MRI films. Generally, a neurologist can look at them and determine what is going at the ventricles. It is most probably cysts which can happen there. Contact the radiology dept at the hospital and they can supply you with the films for the neurologist.

Good luck!
Mary Kay Betz MS RPA-C

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Headache On Top Of Head

by Maria
(Verndale, MN, USA)

Pounding Headache

Pounding Headache

I am a 31 year old woman with a history of minor headaches and some occasional major headaches, but with all of my headaches in the past, ibuprofen or other OTC drugs helped to take the headache away.

On March 26th, exactly two months ago, I developed a headache in the evening that never went away! I was sick with a head cold and a urinary tract infection when the headache developed. The headache is on the top of my head, mostly in the area where my "soft spot" as a baby used to be. I also have considerable pain in the occipital and crown area of the head, but the unbearable pain is at the top of my head.....it makes me cringe sometimes.

I have had MRI's and CTscans...all which came back normal except for the MRI showed that I had a lack of curvature of my cervical spine and that I had a spur in my cervical spine that was touching nothing. I have been to Physical Therapy because the doctor told me that the curvature loss was due to muscle spasms in my neck. The Physical Therapist told me that the headache wasn't responding to the treatment and that I should consider quitting Physical Therapy. I have also been taking muscle relaxants....but they do not take my headache away. Vicodin and Toradol don't even phase the headache....actually.....NOTHING takes the headache away. The only drug that has made my headache bearable and allows me to function daily, was Prednisone...but they quit giving me that because of its long-term use side effects.

My Neurologist prescribed Nortriptyline and I have been on that for almost three weeks and I don't notice it helping at all. I am SOOOO afraid that I have New Daily Persistent Headache which I read usually responds to NO treatment. How can I live with that forever? I am so scared and very frustrated. Have you ever heard of these types of painful constant headache on the top of the head?

Thank you so much. Also, are there any good headache specialists located in Minnesota where I am from?

Maria

Answer:

Hi Maria,

Headache on top of the head can be caused by different types of headaches.

I have seen patients with a new onset of a headache after infection..it is termed post viral headache. There may be a component of inflammation with this headache that you have, since you responded to steroid.

You did not mention whether or not the MRI or CT was done with contrast. I will assume they were. One the MRI, contrast would enable the neurologist to get a look at the meninges (lining the brain) to see if they were inflamed.

Your neurologist is on the right track..headache like this responds to either amitriptyline or nortriptyline and you must start at low dose and work your way up. You may have to get between 50 and 100mg to see a good effect so be patient, give it a good 90 days.

While on this drug to treat this, consider going on feverfew daily which is a gentle anti-inflammatory.

You might also respond to another round of steroid, I would consider IV infusions of steroid two days in a row, followed by oral steroid for 4 weeks. Run this by the neurologist to see if they can set this up for you through home nurses for the infusions.

Failing that, you are lucky enough to have the famous Mayo Clinic in your state. It might be worth the trip. Here is the link to the headache center on theMayo Clinic website. Headache is now a board certified sub-specialty and if there is no specialist in your area, your insurance might approve you being seen at Mayo.

The good news is that you are still in the acute phase and if treated aggressively with nortriptyline, feverfew, and steroids ALL at the same time you may respond..sequential treatment (let's try A..then B..then C) does not work well here.

Good luck!
Mary Kay Betz MS RPA-C

Comments:

Hi Maria,

I have been suffering head pain in the top of my head since the beginning of August (09). I had a CAT scan and a lumbar puncture and both came back fine. No over the counter medication and even the painkillers that they gave me in hospital give me relief. I don't want to take a huge list of medication but if that is my only choice then i suppose i would.

I wanted to know how you are doing and if things improved on their own or if you had to take further medication.

Regards

Amber

Answer:

Hi Amber,
I am posting this and hopefully Maria will answer..have you tried anti-spasmotics? One or two are non-sedating (Skelaxin for instance).

Good luck..
Mary Kay

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