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Suggest Treatment For Severe Headache On Top Middle Part Of Head

Posted on Tue, 31 Mar 2015

Question: My daughter, 53, has been having severe headaches every day, usually on the top middle part of her head. Recently she has been having severe HA in the lower back part of the head, and has not been able to eat as she vomits anything she eats. So far she hasn't found a doctor that will help her find the cause and what to do about it.. She is going to a pain management clinic and gets medicine to help with the pain but whenever she sees a new dr. all they focus on is getting her off pain medicine (morphine IR and ER).

Answered by Dr. Noble Zachariah (1 hour later)

Brief Answer:
If all tests are normal, rebound headache a possibility

Detailed Answer:
Hello,

Welcome and thanks for your query.
I appreciate your concern for your daughter.
As you have not uploaded any test results, can I presume that they are normal?
If not please upload them.
I would like to draw your attention to the entity Medication overuse headache (MOH), also known as rebound headache which usually occurs when analgesics are taken frequently to relieve headaches. Rebound headaches frequently occur daily, can be very painful and are a common cause of chronic daily headache. They typically occur in patients with an underlying headache disorder such as migraine or tension-type headache that transforms over time from an episodic condition to chronic daily headache due to excessive intake of acute headache relief medications. MOH is a serious, disabling and well-characterized disorder, which represents a worldwide problem and is now considered the third-most prevalent type of headache.
If she can be weaned off the analgesics, the pain might stop. If not she should have a CT or MRI scan to detect any organic lesion.
Hope she would be free of headache soon.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (5 days later)

Very thorough answer - would have liked more time to explain the other findings (MRI, CT scan etc.) from an auto accident that could contribute to her headache.

Answered by Dr. Noble Zachariah (9 minutes later)

Brief Answer:
Please upload your results

Detailed Answer:
Thank you for your review.
Please upload your results.
I shall be happy to comment on them

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Noble Zachariah (41 hours later)

I would like to add some other findings to my query about my daughter's headaches. Some time ago she had arachnoiditis (sp?) in her brain, that is still present. I will have to get back to you about the other things found on MRI and CT Scan of her brain. Thank you for your interest, both her and I appreciate your comments. She is also throwing up whenever she eats and becomes very tired. I will be back tomorrow with the other data.

Answered by Dr. Noble Zachariah (3 hours later)

Brief Answer:
Unlikely cause if intracranial pressure is normal

Detailed Answer:
Thank you once again.
Spinal arachnoiditis without raised intracranial pressure is unlikely to produce headache and vomiting. Hope she has been able to reduce the use of painkillers.
She would be helped by relaxing, exercising and eating wholesome healthy food in small portions.
I advise my patients small doses of propranolol if there's no contraindications like asthma, metoclopramide for vomiting if troublesome. Topiramate is another medicine I prescribe for my patients with intractable vascular (throbbing ) headache

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar