[18F] Experiencing persistent sharp and throbbing headache with lightheadedness

Patient Description

An 18-year-old female has been experiencing a sharp and throbbing headache for several days, primarily located at the left back and middle of her head. The headache worsens with movements such as bending down, moving quickly, or transitioning from lying down to standing, and is accompanied by lightheadedness. Ibuprofen provided initial relief but stopped being effective after the first night. This headache is different from previous ones, as it has been persistent and unrelenting. The headache came on suddenly, with no recent head injuries or trauma. No specific triggers other than movement have been identified. The patient has not experienced nausea, vomiting, visual disturbances, neck stiffness, weakness, numbness, tingling, speech difficulties, fever, or chills. There has been a slight reduction in water intake, and the patient is currently on Adderall (25 mg) and sertraline (50 mg) taken every morning, with no recent changes in dosage. She recently stopped taking birth control pills in preparation for an upcoming breast reduction surgery. No known drug allergies and no other medications reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Tension Headache: This is a common type of headache that can cause a dull, aching pain and tightness around the head. It can be triggered by stress, poor posture, or muscle tension. The pain can be persistent and may worsen with movement.

    • Treatment: Over-the-counter pain relievers like ibuprofen or acetaminophen can help. Stress management techniques, such as relaxation exercises, can also be beneficial.
  • Migraine: Migraines can cause severe, throbbing pain, often on one side of the head. They can be accompanied by lightheadedness and sensitivity to movement. Migraines can be triggered by various factors, including stress, hormonal changes, and certain foods.

    • Treatment: Prescription medications are often required to manage migraines. Over-the-counter pain relievers may help in some cases. Identifying and avoiding triggers can also be helpful.
  • Medication Overuse Headache: This can occur if pain relievers are used too frequently, leading to a cycle of persistent headaches.

    • Treatment: Reducing the use of pain medications under the guidance of a healthcare provider can help break this cycle.
  • Cervicogenic Headache: This type of headache originates from issues in the neck and can cause pain in the back of the head. It can be triggered by poor posture or neck strain.

    • Treatment: Physical therapy, posture correction, and pain relievers can help manage this type of headache.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Stay Hydrated: Ensure you are drinking enough water throughout the day.
  2. Rest: Try to rest in a quiet, dark room to minimize discomfort.
  3. Over-the-Counter Pain Relievers: You can try taking ibuprofen or acetaminophen, but avoid overuse.
  4. Relaxation Techniques: Practice deep breathing, meditation, or gentle yoga to reduce stress and muscle tension.
  5. Monitor Your Symptoms: Use MDandMe to journal your symptoms, track progress, and share your notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Sudden, severe headache that feels different from your usual headaches
  • Headache accompanied by fever, stiff neck, confusion, or difficulty speaking
  • Persistent headache that does not improve with over-the-counter medications
  • Any new or worsening symptoms

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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4 mo ago


People Also Ask


What are the common causes of persistent headaches in young adults?

Persistent headaches in young adults can be caused by tension headaches, migraines, medication overuse, dehydration, stress, and changes in medication or lifestyle. It's important to identify the specific type and cause to manage it effectively.


How can I differentiate between a tension headache and a migraine?

Tension headaches typically cause a dull, aching pain and tightness around the head, while migraines often present as severe, throbbing pain on one side of the head, possibly with light sensitivity and nausea. Consulting a healthcare provider can help in distinguishing between the two.


Can stopping birth control pills cause headaches?

Yes, hormonal changes from stopping birth control pills can lead to headaches in some individuals. These headaches are usually temporary as the body adjusts to the hormonal changes.


What are the risks of medication overuse headaches and how can they be prevented?

Medication overuse headaches can occur when pain relievers are used too frequently, leading to a cycle of persistent headaches. To prevent them, it's important to use medications as directed and consult a healthcare provider for a proper treatment plan if headaches persist.


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