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What Causes Intermittent Severe Headache On Right Side?
Question: My mother is getting severe headache on the right side of head since a week. It comes and goes throughout the day. And when it comes, she becomes stiff due to so much pain that she is unable to move her head even an inch.
Her BP is also on the ranges of 100-150. Did consult a general physician and he prescribed Amlopin M, Neurobin Forte, Dolo650 and Pantakind insisting that her pain is due to high BP but she does not feel any difference.
She says the pain pressure has increased from the past 2-3 days. "Before it felt like a headache but now this is not a normal head pain".
The severe spasm like pain is not constant, rather it comes and goes throughout the day but there is a constant bearable dull ache throughout. Please suggest something, please!
I meant to write her BP range is 150-100.
GP suggested to do a Creatinine test which is normal at 0.6 level.
I put my hand on her right head side and I can myself feel the pulsating sensation that pains her. She has never experienced such pain before. It only started a week back and is increasing in severity.
Her BP is also on the ranges of 100-150. Did consult a general physician and he prescribed Amlopin M, Neurobin Forte, Dolo650 and Pantakind insisting that her pain is due to high BP but she does not feel any difference.
She says the pain pressure has increased from the past 2-3 days. "Before it felt like a headache but now this is not a normal head pain".
The severe spasm like pain is not constant, rather it comes and goes throughout the day but there is a constant bearable dull ache throughout. Please suggest something, please!
I meant to write her BP range is 150-100.
GP suggested to do a Creatinine test which is normal at 0.6 level.
I put my hand on her right head side and I can myself feel the pulsating sensation that pains her. She has never experienced such pain before. It only started a week back and is increasing in severity.
Brief Answer:
Please tell further details as I ask.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
Acute onset hemicranial(on one side-right side in your mother's case) throbbing headache,which is episodic and onset dating just one week back, can have the following important etiologies to consider:
1)Primary headache like Migraine or cluster headache
2)Secondary headache-intracranial pathology
3)Hypertension can cause headache,usually holocranial(on both sides) but can be hemicranial also sometimes.
If you would have presented to me as an outpatient,I would have asked you the following questions in order to make an interpretation:
1)You told that she is having recurrent episodes of headache throughout the day-what is the time period for which each episode last?
2)Is headache associated with nausea?
3)Is it associated with any vision abnormalities?
4)Does the headache increase or decrease on talking with others?
5)Does the headache improve in light or in dark?or there is no effect of light or dark?
6)Is the headache associated with redness of right eye or excessive lacrimation from the right eye?Does she have pain behind the eye also?
High blood pressure has to be controlled.It may bring improvement in headache.
Please give the details I asked in follow-up,so that I can answer your query better.Depending on the answers to above questions I asked,she may also have to undergo a brain imaging study like computerised tomographic(CT) scan or magnetic resonance imaging(MRI) of Brain,to see for any intracranial pathology.
Waiting for your follow-up question.
Dr.Ajay Panwar,
MD,DM(Neurology)
Please tell further details as I ask.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
Acute onset hemicranial(on one side-right side in your mother's case) throbbing headache,which is episodic and onset dating just one week back, can have the following important etiologies to consider:
1)Primary headache like Migraine or cluster headache
2)Secondary headache-intracranial pathology
3)Hypertension can cause headache,usually holocranial(on both sides) but can be hemicranial also sometimes.
If you would have presented to me as an outpatient,I would have asked you the following questions in order to make an interpretation:
1)You told that she is having recurrent episodes of headache throughout the day-what is the time period for which each episode last?
2)Is headache associated with nausea?
3)Is it associated with any vision abnormalities?
4)Does the headache increase or decrease on talking with others?
5)Does the headache improve in light or in dark?or there is no effect of light or dark?
6)Is the headache associated with redness of right eye or excessive lacrimation from the right eye?Does she have pain behind the eye also?
High blood pressure has to be controlled.It may bring improvement in headache.
Please give the details I asked in follow-up,so that I can answer your query better.Depending on the answers to above questions I asked,she may also have to undergo a brain imaging study like computerised tomographic(CT) scan or magnetic resonance imaging(MRI) of Brain,to see for any intracranial pathology.
Waiting for your follow-up question.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hi doctor, below are the answers as said by her.
1. At the onset, the spasm lasted 1-2 minutes but now it pains for 10-15 minutes before easing up. Just this morning she was holding her head for 20 minutes before she felt slight better.
2. There is no nausea.
3. She does feel slight vision problem. As in cannot see straight while walking due to the headache.
4. There is a lot of pain when talking to others during that extreme pain phase. She is unable to say a word, the pain is that bad.
5. There is no effect of light or dark.
6. There is no pain in or around the eyes nor any redness or lacrimation.
Her BP was 140-90 last night when we checked at home. Maybe that is due to GP's meds but there is no reduction in the headache whatsoever.
1. At the onset, the spasm lasted 1-2 minutes but now it pains for 10-15 minutes before easing up. Just this morning she was holding her head for 20 minutes before she felt slight better.
2. There is no nausea.
3. She does feel slight vision problem. As in cannot see straight while walking due to the headache.
4. There is a lot of pain when talking to others during that extreme pain phase. She is unable to say a word, the pain is that bad.
5. There is no effect of light or dark.
6. There is no pain in or around the eyes nor any redness or lacrimation.
Her BP was 140-90 last night when we checked at home. Maybe that is due to GP's meds but there is no reduction in the headache whatsoever.
Brief Answer:
Possibly acute migraine/Anti-migraine drugs trial/Brain imaging.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing the details I asked.
This clinical history can be seen in a Migraine variant,though it is not typical of classical migraine.Still,closest differential is 'Migraine'.Your mother needs to be put on anti-migraine therapy trial for now.Please start following medications:
1)Triptans - Rizatriptan(10 mg) or sumatriptan(85 mg);at the time of headache(maximum of 2-3 tablets per week)
2)Tablet amitriptyline 10 mg once a day at bedtime.
3)Non steroidal anti-inflammatory drugs(NSAID) like ibuprofen or naproxen-at the time of headache.
Please let your mother take these medicines and observe for any improvement in symptoms.If symptoms get improved,it will favour the diagnosis of Migraine.
However,I would like you to take her to a neurologist and discuss getting urgent computerised tomographic scan(CT scan) or magnetic resonance imaging(MRI) of brain done.This is a mandatory part of evaluation here as any headache simulating a primary headache which is acute in onset(just one week),needs evaluation with a brain imaging study to rule out secondary causes like brain tumor or some vascular event.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.
Dr.Ajay Panwar,
MD,DM(Neurology)
Possibly acute migraine/Anti-migraine drugs trial/Brain imaging.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing the details I asked.
This clinical history can be seen in a Migraine variant,though it is not typical of classical migraine.Still,closest differential is 'Migraine'.Your mother needs to be put on anti-migraine therapy trial for now.Please start following medications:
1)Triptans - Rizatriptan(10 mg) or sumatriptan(85 mg);at the time of headache(maximum of 2-3 tablets per week)
2)Tablet amitriptyline 10 mg once a day at bedtime.
3)Non steroidal anti-inflammatory drugs(NSAID) like ibuprofen or naproxen-at the time of headache.
Please let your mother take these medicines and observe for any improvement in symptoms.If symptoms get improved,it will favour the diagnosis of Migraine.
However,I would like you to take her to a neurologist and discuss getting urgent computerised tomographic scan(CT scan) or magnetic resonance imaging(MRI) of brain done.This is a mandatory part of evaluation here as any headache simulating a primary headache which is acute in onset(just one week),needs evaluation with a brain imaging study to rule out secondary causes like brain tumor or some vascular event.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Answered by
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