[19F] Experiencing severe headache, nosebleed, hand numbness, and blurry vision

Patient Description

A 19-year-old female presented with a sudden, severe headache described as being hit in the back of the head, which started this morning and worsens upon bending over. Accompanying symptoms include a one-minute nosebleed, sudden blurry vision lasting a few minutes, and transient numbness in the hand leading to dropping an object. These symptoms are new and have not been experienced before. The patient has a history of seizures, with the most recent episode occurring three weeks ago, and is currently on Kepra 500mg twice daily. The patient also has a known allergy to penicillin. No other medications or chronic illnesses were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Migraine: This is a type of headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. However, your symptoms of a sudden, severe headache, along with a nosebleed, blurry vision, and numbness in your hand, are not typical of a migraine.

  • High Blood Pressure (Hypertension): This condition can cause headaches, nosebleeds, and blurry vision. However, it's less likely to cause numbness in your hand.

  • Stroke: This is a medical emergency that occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Symptoms can include a sudden, severe headache, blurry vision, and numbness or weakness in your face, arm, or leg, especially on one side of your body. Given your age and the fact that you have a history of seizures, this is less likely but still possible.

  • Subarachnoid Hemorrhage: This is a type of stroke caused by bleeding in the space surrounding your brain. It can cause a sudden, severe headache, often described as the "worst headache" ever experienced. Other symptoms can include a stiff neck, nausea and vomiting, sensitivity to light, and loss of consciousness. This is a medical emergency.

  • Seizure: Given your history of seizures, it's possible that your symptoms could be related to a seizure. However, your symptoms are not typical of a seizure.

What you can do

Given the severity and sudden onset of your symptoms, it's important to seek immediate medical attention. Please go to the nearest emergency department or call an ambulance.

What you should look out for

Watch out for any worsening of your symptoms or the development of new symptoms, such as difficulty speaking, confusion, trouble walking, dizziness, or severe nausea and vomiting. These could be signs of a serious condition, such as a stroke, and require immediate medical attention.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

People Also Ask


What are the common symptoms of a subarachnoid hemorrhage?

Common symptoms of a subarachnoid hemorrhage include a sudden, severe headache often described as the worst headache ever, a stiff neck, nausea and vomiting, sensitivity to light, and sometimes loss of consciousness. It is a medical emergency and requires immediate attention.


Can high blood pressure cause sudden severe headaches?

Yes, high blood pressure can cause sudden severe headaches, along with other symptoms like nosebleeds and blurry vision. However, it is less likely to cause numbness in the hand.


How can a history of seizures affect the interpretation of new neurological symptoms?

A history of seizures can complicate the interpretation of new neurological symptoms because some symptoms might overlap, such as numbness or changes in vision. However, new symptoms that are atypical for seizures should be evaluated promptly to rule out other serious conditions.


What immediate actions should be taken if someone experiences a sudden severe headache with additional symptoms like numbness or blurry vision?

If someone experiences a sudden severe headache with additional symptoms like numbness or blurry vision, they should seek immediate medical attention by going to the nearest emergency department or calling an ambulance, as these could be signs of a serious condition such as a stroke or subarachnoid hemorrhage.


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