[27F] Experiencing severe, pressure-like headache with nausea and fatigue

Patient Description

A 27-year-old female reports a severe, pressure-like headache encompassing the entire head, with constant pain that has persisted throughout the day. The headache is exacerbated by walking, moving, and standing, and there is no known relief. The patient has experienced similar headaches in the past, which used to occur daily but now happen once or twice a month. Accompanying symptoms include nausea and fatigue. The patient denies any changes in the characteristics of the headache over time, as well as any visual changes, stiff neck, fever, or neurological symptoms. There is no family history of similar headaches or migraines. The patient's medication regimen includes valacyclovir 500mg, trazodone 50mg, vitamin D3 100mg, iron 50mg, and prenatal vitamins, all taken once daily. There is no known drug allergy or history of chronic illnesses or pre-existing conditions.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, the following conditions could be causing your discomfort:

  • Tension Headache: This is the most common type of headache and it often feels like a constant ache or pressure around the head, especially at the temples or back of the head and neck. It can be triggered by stress, anxiety, lack of sleep, or skipping meals.

    • Treatment typically involves over-the-counter pain relievers. Preventative measures include stress management, regular exercise, and ensuring you get enough sleep and nutrition.
  • Migraine: Migraines are a type of headache characterized by severe throbbing or pulsing sensation, often on one side of the head. They are often accompanied by nausea, vomiting, and sensitivity to light and sound. However, you did not mention sensitivity to light or sound, which are common in migraines.

    • Treatment typically involves medications to relieve symptoms and prevent future attacks. Lifestyle changes such as regular sleep, meals, and exercise can also help.
  • Anemia: Given that you are taking iron supplements, it's possible that you have been diagnosed with anemia in the past. Fatigue is a common symptom of anemia, and some people also experience headaches and dizziness.

    • Treatment typically involves iron supplements, which you are already taking.

Please note that this is not an exhaustive list and other conditions could also explain your symptoms.

What you can do

  1. Over-the-counter pain relievers such as ibuprofen or acetaminophen may help relieve your headache. Be sure to follow the instructions on the bottle and do not exceed the recommended dose.
  2. Try to rest in a quiet, dark room. This can sometimes help with headaches.
  3. Stay hydrated and try to eat regular, balanced meals. Skipping meals can sometimes trigger headaches.
  4. Regular physical activity can help prevent headaches. Try to incorporate some form of exercise into your daily routine.
  5. If your headaches continue, you should make an appointment to see your doctor. They can provide a formal diagnosis and discuss treatment options with you.

What you should look out for

You should seek immediate medical attention if:

  • Your headache is severe and sudden, like a thunderclap
  • You have a headache along with a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • Your headache gets worse over time
  • You have a headache after a head injury
  • You have a chronic disease such as HIV or cancer and develop a new headache

Remember, I'm an AI and this advice is based on the information you provided. It's always a good idea to consult with a healthcare professional for an accurate diagnosis.

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9 mo ago


People Also Ask


What are the common triggers for tension headaches?

Common triggers for tension headaches include stress, anxiety, lack of sleep, poor posture, and skipping meals. Identifying and managing these triggers can help reduce the frequency of headaches.


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

Tension headaches typically present as a constant, pressure-like pain around the head, while migraines often involve a throbbing or pulsing sensation, usually on one side of the head, and may be accompanied by nausea, vomiting, and sensitivity to light and sound.


What lifestyle changes can help prevent frequent headaches?

Lifestyle changes that can help prevent frequent headaches include maintaining a regular sleep schedule, eating balanced meals at regular intervals, staying hydrated, managing stress through relaxation techniques, and engaging in regular physical activity.


What are the symptoms of anemia that might accompany headaches?

Symptoms of anemia that might accompany headaches include fatigue, weakness, dizziness, pale skin, and shortness of breath. If you suspect anemia, it's important to consult a healthcare provider for proper diagnosis and treatment.


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