[36M] Experiencing severe headaches and visual disturbances

Patient Description

A 36-year-old male reports severe, variable headaches and visual disturbances including temporary blindness and white blotches, with eye pain rated 10/10. Symptoms have persisted for 5-6 years and are worsening, with no specific triggers identified. The patient has a history of a significant head injury from brass knuckles, with subsequent imaging revealing left frontal lobe shrinkage. Additional medical history includes cancer, liver failure, kidney failure, and extremely dry eyes diagnosed in 2020. The patient uses alcohol to temporarily alleviate headache symptoms and is currently not on any medications. No known drug allergies. The patient experiences nausea and vomiting, particularly when eating, and occasional confusion and weakness associated with headaches.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, the following conditions could be possible:

  • Migraines: These are severe headaches often accompanied by nausea, vomiting, and sensitivity to light. They can sometimes cause visual disturbances known as "auras". It's possible that your migraines have become chronic and more severe over time.

    • Treatment typically involves medications to relieve symptoms and prevent future attacks. Lifestyle modifications can also help manage migraines.
  • Cluster Headaches: These are extremely painful headaches that occur in clusters or cycles. They are often accompanied by symptoms such as red or teary eyes, runny or stuffy nose, and facial sweating, flushing, or swelling.

    • Treatment typically involves medications to shorten attacks and prevent them from occurring.
  • Temporal Arteritis: This is an inflammation of the arteries in your head, particularly those in your temples. Symptoms can include severe headache, scalp tenderness, jaw pain, vision problems, and even blindness.

    • Treatment typically involves high doses of a corticosteroid drug.
  • Brain Tumor: While less likely, a brain tumor can cause symptoms such as persistent headaches, vision problems, nausea, and vomiting. Given your history of cancer, it's important to rule this out.

    • Treatment typically involves surgery, radiation therapy, and chemotherapy.

Please note that these are potential explanations for your symptoms based on the information you've provided, but they are not definitive diagnoses. It's crucial to consult with a healthcare provider for a proper evaluation and diagnosis.

What you can do

Given the severity of your symptoms, it's important to seek immediate medical attention. Here are some steps you can take:

  1. Go to the emergency department: Your symptoms are severe and worsening, which warrants immediate medical attention.
  2. Consult with a neurologist: A neurologist specializes in conditions affecting the brain and may be able to provide further insight into your symptoms.
  3. Keep a symptom diary: Note down when your headaches occur, their severity, any triggers you've identified, and any accompanying symptoms. This can help your healthcare provider in diagnosing your condition.

What you should look out for

Please seek immediate medical attention if you experience:

  • A sudden, severe headache like a thunderclap
  • A headache accompanied by a 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 in the morning

Remember, I'm an AI and this advice is based on the information you've provided. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

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People Also Ask


What are the common symptoms of migraines and how can they be managed?

Migraines are often characterized by severe, throbbing headaches, usually on one side of the head, accompanied by nausea, vomiting, and sensitivity to light and sound. Visual disturbances, known as auras, can also occur. Management includes medications to relieve symptoms and prevent future attacks, as well as lifestyle changes such as stress management and avoiding known triggers.


How do cluster headaches differ from other types of headaches?

Cluster headaches are extremely painful and occur in cyclical patterns or clusters. They are typically shorter in duration than migraines but can occur multiple times a day. Symptoms include intense pain around one eye, red or teary eyes, and nasal congestion. Treatment focuses on relieving pain quickly and preventing future attacks.


What is temporal arteritis and what are its potential complications?

Temporal arteritis is an inflammation of the arteries in the head, particularly the temples. It can cause severe headaches, scalp tenderness, jaw pain, and vision problems, including blindness if untreated. High doses of corticosteroids are typically used to reduce inflammation and prevent complications.


Can a past head injury lead to long-term neurological issues like headaches and vision problems?

Yes, a past head injury can lead to long-term neurological issues, including chronic headaches and vision problems. Damage to the brain, such as shrinkage of the frontal lobe, can affect various functions and may contribute to ongoing symptoms. It's important to have these symptoms evaluated by a healthcare professional.


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