[28F] Experiencing severe, sudden-onset headache with neck stiffness and light sensitivity

Patient Description

A 28-year-old female reports a sudden onset of a severe headache approximately 4 hours ago, described as sharp and aching. The pain is primarily located in the back of the head and upper neck area, radiating to the top of the head, behind the eyes, and by the eyebrows and temples. The headache intensifies with neck or head movement. The patient also experiences nausea, light sensitivity, and neck stiffness. There is a recent history of an ear infection treated with medication, leading to a clogged and ringing right ear for the past 4 days. Additionally, the patient noted some blood when blowing her nose. The only medication taken for the headache was Tylenol (500mg), which has not provided relief. The patient also received a Brixadi injection 2 days ago. No past medical history of similar headaches, migraines, or chronic illnesses was reported. No recent head injury, fever, changes in consciousness, or new rash were noted.

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Arora's Assessment

What might be happening

Based on the information you've provided, the possible causes of your symptoms include:

  • Migraine: This is a type of headache characterized by severe, throbbing pain usually on one side of the head. It can be accompanied by symptoms such as sensitivity to light and sound, nausea, and vomiting. However, you mentioned that you and your family have no history of migraines, which makes this less likely.

    • Treatment typically involves pain relievers, anti-nausea medications, and preventive medications to reduce the frequency and severity of migraines.

  • Tension headache: This is a common type of headache characterized by a dull, aching sensation all over the head. It is often described as a feeling of a tight band or dull ache around the head or behind the eyes. These are often related to stress, depression, or anxiety. Over-the-counter pain relievers such as aspirin, ibuprofen, or acetaminophen can be effective.

  • Cluster headache: This is a rare type of headache that occurs in cyclical patterns or clusters. It is one of the most painful types of headache, with intense burning or piercing pain behind or around one eye, and may be accompanied by redness, swelling, or tearing of the eye.

    • Treatment typically involves medications to lessen the severity and frequency of the cluster headaches.

  • Sinusitis: This is an infection or inflammation of the sinuses, often caused by a viral or bacterial infection. Symptoms can include headache, facial pain, and nasal congestion. Since you mentioned having a recent ear infection and some blood when you blow your nose, this could be a possibility.

    • Treatment typically involves antibiotics, decongestants, and pain relievers.

  • Medication-overuse headache: This type of headache occurs when medications are taken too frequently to relieve headaches, leading to a rebound headache. It's less likely in your case as you've only taken Tylenol once.

Please note that this is not an exhaustive list and other causes may be possible.

What you can do

Given the severity and sudden onset of your symptoms, it's important to seek immediate medical attention. While waiting for medical help:

  1. Try to rest in a quiet, dark room.
  2. Stay hydrated.
  3. Avoid activities that worsen your headache.

What you should look out for

Seek immediate medical attention if you experience:

  • An abrupt, severe headache like a thunderclap
  • Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • Headache after a head injury, especially if the headache worsens
  • A chronic headache that is worse after coughing, exertion, straining, or a sudden movement
  • New headache pain if you're over 50

Remember, I'm an AI and this advice is based on the symptoms you've told me. It's important to consult with a healthcare professional who can evaluate your condition.

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7 mo ago

People Also Ask

What are the common symptoms of a sinus infection?

Common symptoms of a sinus infection include facial pain or pressure, nasal congestion, thick nasal discharge, reduced sense of smell, headache, fever, and sometimes tooth pain.

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

Migraines are often characterized by severe, throbbing pain on one side of the head, accompanied by nausea, vomiting, and sensitivity to light and sound. Tension headaches typically involve a dull, aching sensation all over the head, often described as a tight band around the head or pressure behind the eyes.

What should I do if over-the-counter medications do not relieve my headache?

If over-the-counter medications do not relieve your headache, it is important to consult a healthcare professional for further evaluation and treatment options. They may prescribe stronger medications or investigate other underlying causes.

When should I seek immediate medical attention for a headache?

You should seek immediate medical attention for a headache if it is abrupt and severe like a thunderclap, accompanied by fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties, or if it occurs after a head injury and worsens.

1 Comments

Leo#3962

7 mo ago

hm, do you feel that the ear infection has completely resolved or could it be related? one trick that works for me to resolve headaches is wearing a toque on my head and sleeping. If it's still there tomorrow let me know and we can brainstorm more.

And if the headache is super severe, you experience vision loss, or you experience jaw pain when chewing (this in combination with pain behind your eyes and temples could suggest temporal arteritis which is an emergency) please go the emergency room

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