[34F] Experiencing sharp headache with vomiting and tingling in hands

Patient Description

A 34-year-old female presents with a sharp pain on the left side of her head, which has persisted for 3 days. The pain, rated at a 5 out of 10 in intensity, is located in the middle of the temple and back of the head, and is exacerbated by laughing or coughing. Vomiting was noted on the first day of the headache. The patient also experiences tingling in the hands. There have been no changes in vision, speech, mental status, or any weakness or numbness in the body. The patient has a history of Ulcerative colitis diagnosed in 2013 and is currently on Remicade. No known drug allergies or other medications reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses 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 other symptoms such as nausea, vomiting, and sensitivity to light and sound. Migraines can be triggered by various factors including stress, certain foods, hormonal changes, and lack of sleep.

    • Treatment for migraines often involves medications to relieve symptoms and prevent future attacks.
  • Tension headache: This is the most common type of headache, often described as a constant ache or pressure around the head, especially at the temples or back of the head and neck. They can be triggered by stress, lack of sleep, poor posture, or eye strain.

    • Treatment usually involves over-the-counter pain relievers, stress management techniques, and lifestyle changes.
  • Cluster headache: This is a rare type of headache that occurs in cyclical patterns or clusters. It's one of the most painful types of headache, with intense burning or piercing pain behind or around one eye, and it can be accompanied by tearing, redness, or swelling of the eye on the affected side, a runny or stuffy nose, and restlessness.

    • Treatment involves medications to decrease the severity of the headache, as well as preventive medications to reduce the frequency and duration of the headaches.
  • Trigeminal neuralgia: This is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. It causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as 2 minutes per episode.

    • Treatment usually involves medications, injections, or in some cases, surgery.
  • Secondary headaches: These are headaches that are symptoms of another health disorder. They can be caused by a variety of conditions, including sinus infection, brain tumor, or problems with the blood vessels in the brain. The fact that your headache is worsened by coughing or laughing (which increases pressure in the head) could be a sign of a secondary headache.

    • Treatment involves addressing the underlying condition.

Please note that this is not an exhaustive list and other diagnoses are also possible.

What you can do

You should seek immediate medical attention given the severity and sudden onset of your symptoms. It's important to get a proper diagnosis and appropriate treatment. In the meantime, try to rest and stay hydrated. Avoid any known headache triggers, if possible.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • A sudden, severe headache like a thunderclap
  • A headache accompanied by fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or speaking difficulties
  • A headache after a head injury, especially if the headache gets worse
  • 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 information you've provided. It's always important to consult with a healthcare professional for an accurate diagnosis and treatment.

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1 yr ago

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People Also Ask


What are the common triggers for migraines?

Common triggers for migraines include stress, certain foods (like aged cheese and processed meats), hormonal changes, lack of sleep, and sensory stimuli such as bright lights or loud sounds.


How can tension headaches be managed at home?

Tension headaches can often be managed at home with over-the-counter pain relievers, stress management techniques such as relaxation exercises, maintaining good posture, and ensuring adequate sleep.


What distinguishes a cluster headache from other types of headaches?

Cluster headaches are distinguished by their cyclical pattern, intense burning or piercing pain around one eye, and accompanying symptoms like tearing, redness, or swelling of the eye, and a runny or stuffy nose.


When should someone seek medical attention for a headache?

Medical attention should be sought for a headache if it is sudden and severe, accompanied by symptoms like fever, stiff neck, confusion, seizures, or weakness, or if it follows a head injury and worsens.


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