[40F] With sudden severe headache and visual disturbances

Patient Description

A 40-year-old female presents with a severe headache rated 9 out of 10, persisting for five days. The pain is located at the back of the head and behind the eyes. The headache began suddenly and is accompanied by light sensitivity, nausea, visual blurriness, seeing halos, and ringing in the ears. There is no history of similar headaches, weakness, numbness, difficulty speaking, or confusion. The patient has a history of bipolar disorder, diagnosed in her teens, and is currently on Lithium (100 mg twice daily) and Trazadone (150 mg once daily). No known drug allergies.

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Arora's Assessment

What might be happening

Based on your symptoms, there are a few possibilities to consider:

  1. Migraine with Aura: Your symptoms, including a severe headache, light sensitivity, visual disturbances, and nausea, are common in migraines with aura. These can cause changes in vision and other sensory disturbances.

  2. Acute Glaucoma: Sudden headaches with visual changes and eye pain can be a sign of acute glaucoma, which is an emergency condition that requires immediate attention to prevent vision loss.

  3. Other Neurological Issues: While less likely given the absence of other neurological symptoms, it's important to rule out conditions like a brain aneurysm or other vascular issues.

What you can do

  • Seek Immediate Medical Attention: Given the severity and sudden onset of your symptoms, it's crucial to see a healthcare professional as soon as possible. Consider going to the emergency room or an urgent care center.

  • Avoid Bright Lights: Until you can see a doctor, try to stay in a dimly lit environment to reduce discomfort from light sensitivity.

  • Stay Hydrated: Drink plenty of water, as dehydration can sometimes worsen headaches.

  • Monitor Symptoms: Keep track of any new symptoms, such as changes in vision, increased pain, or any neurological changes like weakness or confusion.

Please seek care from a healthcare professional immediately to receive a formal diagnosis and appropriate treatment. If your symptoms worsen or you feel unsafe, call 911 or have someone take you to the hospital.

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2 mo ago


People Also Ask


What are the common symptoms of a migraine with aura?

Common symptoms of a migraine with aura include severe headache, visual disturbances such as seeing halos or flashing lights, light sensitivity, nausea, and sometimes tingling or numbness in the face or hands.


How can acute glaucoma be identified and why is it an emergency?

Acute glaucoma can be identified by sudden severe headache, eye pain, visual disturbances, nausea, and vomiting. It is an emergency because it can lead to permanent vision loss if not treated promptly.


What are the potential risks of untreated severe headaches?

Untreated severe headaches can lead to complications such as chronic migraine, increased risk of stroke, or in rare cases, they may be a sign of a more serious condition like a brain aneurysm or tumor.


Can medications for bipolar disorder like Lithium and Trazadone cause headaches?

While headaches are not a common side effect of Lithium and Trazadone, any new or worsening symptoms should be discussed with a healthcare provider to rule out medication interactions or side effects.


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