[52F] With unilateral throbbing headache and neck stiffness

Patient Description

A 52-year-old female presents with a dull, throbbing pain originating from the base of the skull on the right side, radiating forward to the forehead. The headache is constant, with a pulsing sensation, and has been present for four days. The right side of the head feels hot and swollen. The pain worsens with coughing and touching behind the ear. The patient also experiences nausea and neck stiffness but denies any sensitivity to light or sound, visual disturbances, recent injuries, infections, or travel. She reports regular use of tobacco (one pack of cigarettes daily) and caffeine (two cups of coffee daily), with no recent changes in consumption. The headache severity is rated as 8 out of 10, and no relief has been found through rest, medication, or cold compresses. The patient does not report fever or chills.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—dull throbbing headache on the right side of your head, neck stiffness, nausea, and chills—there are a few possibilities to consider:

  1. Meningitis: This is an inflammation of the membranes surrounding your brain and spinal cord. Symptoms can include a severe headache, neck stiffness, fever, and chills. Meningitis can be serious and requires immediate medical attention.

  2. Migraine: Migraines can cause severe, throbbing pain, often on one side of the head, and may be accompanied by nausea. However, neck stiffness and chills are not typical for migraines.

  3. Cervicogenic Headache: This type of headache is caused by a disorder of the cervical spine and can result in pain that radiates from the neck to the head. It might be associated with neck stiffness but not usually with nausea or chills.

Given the combination of your symptoms, especially the neck stiffness and chills, it's important to seek medical attention promptly to rule out any serious conditions like meningitis.

What you can do

  1. Seek Immediate Medical Attention: Given the seriousness of your symptoms, it's crucial to visit a healthcare professional as soon as possible. They can perform the necessary tests to determine the cause of your symptoms and provide appropriate treatment.

  2. Stay Hydrated: Drink plenty of fluids to stay hydrated, especially if you're experiencing nausea.

  3. Rest: Try to rest in a quiet, dark room to help alleviate some of the headache symptoms.

  4. Avoid Triggers: If you notice certain activities or foods that worsen your symptoms, try to avoid them.

Please remember that while I can provide information, it's essential to consult with a healthcare professional for a formal diagnosis and treatment plan. If your symptoms worsen or you experience new symptoms, seek medical attention immediately.

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People Also Ask


What are the common symptoms of meningitis?

Common symptoms of meningitis include severe headache, neck stiffness, fever, chills, nausea, vomiting, and sensitivity to light. It is a serious condition that requires immediate medical attention.


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

Migraines typically present with severe, throbbing pain on one side of the head, often accompanied by nausea and sensitivity to light and sound. Cervicogenic headaches originate from the neck and may radiate to the head, often without nausea or sensitivity to light and sound.


What lifestyle changes can help reduce the frequency of headaches?

Lifestyle changes that can help reduce headache frequency include maintaining a regular sleep schedule, staying hydrated, managing stress, avoiding known headache triggers (such as certain foods or activities), and reducing caffeine and tobacco use.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it is sudden and severe, accompanied by symptoms like neck stiffness, fever, confusion, or if it does not improve with over-the-counter medications. Persistent headaches that interfere with daily life also warrant a medical evaluation.


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