What Causes Constant Headaches?

Posted on Mon, 17 Mar 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 17 Mar 2014 Answered on

Tue, 15 Apr 2014 Last reviewed on

Question : Question for Neurologist I have been getting a headache pain that is constant. It gets worse in the end of the day. Feels like it starts in my neck and sometimes goes to my temples or both my eye brows. Certain muscles refer pain when I push on them in my neck. I get these pretty often.

Answered by Dr. Sudhir Kumar (3 hours later)

Brief Answer: Features suggest muscle tension headache Detailed Answer: Hi, Thank you for posting your query. First of all, I would like to reassure you that your symptoms do not suggest ants serious disease. The most likely cause could be muscle tension headache. The medications that help in this condition are amitriptyline and dothiepin. The usual starting dose is 25 mg given once daily at bedtime, and the dose may be increased to 50-75 mg depending on the response. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, India Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in

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

Follow up: Dr. Sudhir Kumar (5 minutes later)

I had a CT scan a year and half ago and was all clear. Should these ease my concerns about anything being bad in there causing this. Could something bad had formed since then? I hear bad things like cancer take a long time to form, etc. I know people always think something bad when talking about headaches

Answered by Dr. Sudhir Kumar (2 minutes later)

Brief Answer: Yes, normal CT is a good news! Detailed Answer: Normal CT about a year and half ago is reassuring and excludes most serious conditions. Regarding cancer, it grows fast and within 3-6 months becomes aggressive, if untreated. So, in your case, I do not think you have any real chance of having cancer. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (1 minute later)

What serious conditions does it exclude. Do you think I need more scans? If it was something more serious does it present differently? Reason I ask is my wifes dad had a brain tumor when he was 40 something and he said his doctor told him it was probably growing for years. Also if it was something bad in there that meds like pain pills, etc would not make the pain go away in which it does mine.

Answered by Dr. Sudhir Kumar (31 minutes later)

Brief Answer: Further tests may include MRI or PET scan. Detailed Answer: Thank you for getting back. As I told earlier, I do not expect brain tumor in your case, as your symptoms are not suggestive of that. Patients with brain tumor have early morning headache, vomiting, blurred vision, fits, weakness of one arm or leg, etc. Also, good relief to medications as in your case is not the norm in people with brain tumor. However, if you are anxious or want to be 100% sure, then, further scans may include MRI brain or PET scan brain. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (1 minute later)

Can stress cause the type of headache I have? Forgot to ask about blood pressure. Does high blood pressure cause headaches? Mine is 155/95

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer: Yes uncommonly. Detailed Answer: High BP can cause headaches in about 10% of people. However, your BP is mildly high and can be easily controlled. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (37 hours later)

So with a clear CT scan in late 2012 you think I should not worry ? You forgot to answer what does a Brain CT scan exclude

Answered by Dr. Sudhir Kumar (8 minutes later)

Brief Answer: Normal CT Scan excludes the following: Detailed Answer: Brain tumor Blood clots known as infarcts Brain hemorrhage Infections such as brain abscess. These are all excluded by a normal CT scan of brain. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (3 minutes later)

I took a milligram of Xanax and it makes my headaches go away. Is that common?Also got a cat scan of my brain in 2012 would it still mean I am good and all that stuff is excluded

Answered by Dr. Sudhir Kumar (19 hours later)

Brief Answer: Yes, xanax can relieve the headaches. Detailed Answer: CT scan of 2012 is good if you had the same symptoms then also. However, if the symptoms are more severe now, you may repeat the CT or MRI scan of brain. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (1 hour later)

Well seems like the pain may be a little more frequent. But let me tell you where it is. It does not seems like in my head it seems like it's in the muscles running up my neck. Like the muscle below my ears. They are really tender. They get more tender as the day goes on. I can take my finger and push them and pain radiates. Kind of like trigger points. Does that warrant another scan. I just started 25 milligrams of amitriplyine 2 nights ago, how long before that really takes effect? I really don't have new symptoms like weakness, visual disturbances, speech problems or anything like that. Just tension in my neck from muscles.

Answered by Dr. Sudhir Kumar (3 hours later)

Brief Answer: Another scan is not warranted. Detailed Answer: Thank you for getting back. I have noted your symptoms and feel that a new scan is not required at this stage. It may take about two weeks to show the effect of 25 mg amitriptyline. It is good to note that there are no new symptoms. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (9 days later)

Sir, My doctor sent me for a Brain CT scan on a new 128 slice machine we have in town. A neuroradiologist read the results. Are they good at seeing brain issues.

Answered by Dr. Sudhir Kumar (43 minutes later)

Brief Answer: Yes, neuroradiologist are trained for that. Detailed Answer: Thank you for getting back. A neuroradiologist is well trained to see the brain tissues. So, his report on CT brain would give us the answers. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (7 minutes later)

He did say this in his report: Acute intracranial hemorrahage: None. A linear focus of hyperattenuation along the course of posterior falx cerebri is thought to represent a prominent extra- axial vein. That sounds worrisome? His Final Impression says this: 1. Negative for acute intracranial hemorrhage, mass lesion or CT evidence of acute ischemic infarction. Read by Neuroradiologist

Answered by Dr. Sudhir Kumar (4 minutes later)

Brief Answer: Vein in that location is normal. Detailed Answer: Thank you for getting back. I have noted the report of the neuroradiologist. I would like to reassure you that the report is normal. The vein mentioned in the report is a normal finding. So, there is no need to worry about that. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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