Brief Answer:
Yes, an ER consult would be a good idea with such a presentation

Detailed Answer:
Hello and Welcome

I appreciate your concern

Aneurysms are may not show any symptoms until the point of their rupture. Sudden onset of severe headache is the hallmark of the aneurysm. Based on your description, its unlikely to be a brain aneurysm. If you have pins and needles or paresthesia and heaviness on the left side then you should go to an ER or stroke unit near you to get evaluated. A neurological exam would give important clues whether to go for brain imaging or not. A CTA or MRA can be advised if suspicion of berry aneurysm is not resolved despite the examination or if there is history of polycystic kidney disease and other connective tissue disorders that commonly associated with berry aneurysm of the brain. If no focal neurological deficit is determined and the neurological exam is unremarkable then an x ray or CT of the para nasal sinuses can be advised to look for opacification of the sinuses , deviation of the nasal septum as sinusitis can also present with similar headaches. Evaluation and treatment for migraine headaches should be considered if the sinuses are normal and no evidence of sinusitis is found. NSAIDs and muscle relaxants can be prescribed empirically in addition to physiotherapy for the neck pain. If no improvement occurs then a cervical spine x ray / MRI +/- NCS/EMG can be advised to look for other causes such as a radiculopathy, cervical spondylosis and others.


Wishing you best of health

Thanks

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

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Brief Answer:
Explained

Detailed Answer:
Hello again.

Yes, Madam. Based on your description, its highly possible. Treatment for sinusitis is quite simple with antibiotics and decongestants, so it should be evaluated. There may also be associated tenderness of the overlying bones of sinuses involved.

Let me know if you have any query

Wishing you best of health

Thanks

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Brief Answer:
Explained

Detailed Answer:
Hello again.

Headache increasing upon lying down is commonly seen with hypertension, stress/anxiety and fibromyalgia.

This specific complain of increased headache on lying will not alter the above work greatly. Thyroid function tests , ESR both should be done. Blood pressure measurements should also be done.

Fatigue, memory problems and generalized musculoskeletal pain with mood issues should also be addressed.


Please contact me for any follow up query that you might have. I will be more than glad to address it.

Wishing you best of health

Thanks

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