[30F] Experiencing headache with pressure

Patient Description

A 30-year-old female reports a headache that has persisted for 14 hours. The pain is localized to the right temple and the back of the neck, described as a pressure sensation, with a severity of 6 out of 10. The headache worsens upon getting up and coughing. Tylenol (Acetaminophen) at a dose of 500mg every 6 hours provides some relief. The patient has a medical history of asthma and a bicuspid aortic valve, both diagnosed in 2016. There are no known allergies or adverse reactions to medications. No other symptoms such as fever, vision changes, or sensitivity to light or sound were reported. The patient also notes stiffness in the right side of the neck but no recent head injury, changes in consciousness, or seizures. No other medications are being taken except for Tylenol for the headache.

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Arora's Assessment

What might be happening

Based on the information you provided, the most likely causes for your headache could be:

  • Tension Headache: This is the most common type of headache and it often feels like a tight band around your head or a weight on top of it. Your neck or shoulder muscles may also hurt along with the headache. This could be caused by stress, anxiety, or holding your head in one position for a long time (like when you use a computer).

    • Treatment usually involves over-the-counter pain relievers, rest, and stress management.
  • Cluster Headache: These are severe headaches that occur on one side of the head (often around the eye) and come in clusters, meaning you experience cycles of headache attacks, followed by headache-free periods.

    • Treatment usually involves prescription medications to decrease the severity of the cluster headache, as well as preventive medications to decrease the frequency.
  • Migraine: This is a type of headache characterized by severe pain on one or both sides of the head, nausea, and, sometimes, disturbed vision. It can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

    • Treatment usually involves over-the-counter or prescription medications to stop the headache and prevent future attacks.

What you can do

It's important to consult a healthcare professional for an accurate diagnosis and treatment. In the meantime, here are some things you can do:

  1. Rest and avoid any triggers that you notice make your headaches worse.
  2. Over-the-counter pain relievers, such as the Tylenol you're already taking, can help. Make sure to follow the dosing instructions on the package.
  3. Try to reduce stress, as it can often contribute to headaches. This could include relaxation techniques such as deep breathing, yoga, or meditation.
  4. Regular physical activity and a healthy diet can also help prevent headaches.

What you should look out for

Seek immediate medical attention if:

  • Your headache is sudden and severe
  • You have a headache accompanied by confusion, fainting, high fever, or other neurological symptoms
  • You have a history of headaches but they have changed in pattern or intensity
  • You have a headache following a head injury

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, diagnosis, and treatment.

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1 yr ago

People Also Ask


What are the common causes of headaches that last more than 12 hours?

Common causes of headaches lasting more than 12 hours include tension headaches, migraines, and sometimes cluster headaches. Other potential causes could be dehydration, sinus issues, or more serious conditions like a brain aneurysm, though these are less common.


How can tension headaches be distinguished from migraines?

Tension headaches typically present as a constant, dull pain or pressure around the forehead or back of the head and neck, often described as a tight band. Migraines, on the other hand, are usually more severe, can be throbbing, and are often accompanied by nausea, vomiting, and sensitivity to light and sound.


What are the recommended treatments for headaches associated with neck stiffness?

For headaches with neck stiffness, over-the-counter pain relievers like acetaminophen or ibuprofen can be helpful. Applying heat or cold packs to the neck, gentle stretching, and maintaining good posture can also alleviate symptoms. If the headache persists, it's important to consult a healthcare provider.


When should someone seek medical attention for a persistent headache?

Medical attention should be sought if the headache is sudden and severe, if it is accompanied by confusion, fainting, high fever, or other neurological symptoms, if there is a change in the pattern or intensity of a known headache, or if it follows a head injury.


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