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Neurology (Expert Forum)
Skull Pain
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Skull Pain
by Aneesa, Dec 03, 2006 12:00AM
Hi. Desperate for help for my husband. He had an operation 3 weeks ago for the removal of a cyst from his testicles. He was required to rest for 1 week. 4 days after op he started having what he described as a 'severe headache'. It seems to be in the back right side of skull. His headache is now so strong that he has trouble when he walks ie. constantly wincing with pain when he moves his head. Says he his not getting any pain in his neck or anywhere else just purely a 'severe throbbing' in back of skull (always in same place). It is more prominent in the afternoon/night and only eases slightly when he is laying down on his back. He has taken strong pain killers, acupunture, reflexology with no luck/relief whatsoever. He had a CAT scan last week which came back clear. Extremely grateful for any help/advice......Aneesa
Doctor's Answer
by CCF-Neuro-M.D.-SH, Dec 23, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms you describe are most consistent with migraine headaches. If he has never had these type headaches before, there are several things in his current condition that might have lead to them. First, after surgery, many people take regular (daily or more) narcotic or other pain medications. This can lead to rebound headaches in susceptible people. Second the stress of the surgery and the disruption of his sleeping routine, can also precipitate headaches in some people. Of course, the first thing you should do is make sure these are not symptomatic headaches (from a tumor, vascualr malformation, etc.). The CT scan is a decent first step, but you need a MRI of the brain with contrast. Second, you should stop taking pain medication more than 2 times per week, and start a headache preventative medication(such as elavil, topamx, nadolol, etc). This is not easy, and in difficult cases a steroid taper is helpful to ease the transition over to the prevenative medication. In severe cases, patients may require admission to the hospital for IV infusions of Magnesium, Depakote and DHE. Migraines in general "feel better" when lying still, in a dark place that is quiet. However the fact that your husbands headache improves with lying down could also suggest a CSF leak, although this would be very uncommon after a testicular surgery.
I hope this has been helpful.
The symptoms you describe are most consistent with migraine headaches. If he has never had these type headaches before, there are several things in his current condition that might have lead to them. First, after surgery, many people take regular (daily or more) narcotic or other pain medications. This can lead to rebound headaches in susceptible people. Second the stress of the surgery and the disruption of his sleeping routine, can also precipitate headaches in some people. Of course, the first thing you should do is make sure these are not symptomatic headaches (from a tumor, vascualr malformation, etc.). The CT scan is a decent first step, but you need a MRI of the brain with contrast. Second, you should stop taking pain medication more than 2 times per week, and start a headache preventative medication(such as elavil, topamx, nadolol, etc). This is not easy, and in difficult cases a steroid taper is helpful to ease the transition over to the prevenative medication. In severe cases, patients may require admission to the hospital for IV infusions of Magnesium, Depakote and DHE. Migraines in general "feel better" when lying still, in a dark place that is quiet. However the fact that your husbands headache improves with lying down could also suggest a CSF leak, although this would be very uncommon after a testicular surgery.
I hope this has been helpful.
