Headache back of head - should I be concerned?

Thanks in advance for looking at this.

About me: 25-year-old male, 5' 10" 240 lbs., phyiscal a month ago, blood work fine except for high cholesterol, no smoking/drugs, yes alcohol, sexually active and monogamous.

For the past few weeks I've been experiencing occasional (3-4 times a week) headaches in the back of my head (above the "soft part" where the skull ends).  These headaches aren't very severe in terms of pain, but they're concerning to me because they're new, they're always similar, and I've never really had headache problems previously.

They tend to come on in the morning, after I get to work and eat breakfast.  I can feel them coming on, and they are usually accompanied by mild disorientation, nausea (never vomiting yet), and distractability. I usually take one Aleve when I feel them coming on, which provides pain relief, but I can still feel some effects (head pressure, occasional strange feeling of blood flowing around the head, some of the mental effects).

I scheduled an appointment with a headache-specializing neurologist, but their next available appointment was in mid January, six weeks from now.  Should I be concerned and pursue any sorts of diagnostic (imaging?) tests before that?

Thanks so much for looking at this.

[J.M. Keyes, MD]

Hi there,
Because you are having other symptoms accompanying your headaches, like disorientation, I would have it checked out sooner than 6 weeks.  I don't like the idea of just going somewhere on your own to get imaging, because if there is anything wrong you have no one to follow up with you, and you really should have someone take a full history and do a physical to determine the exact test that you should have.  You can see a family doctor or internist (or maybe another neurologist) fairly quickly, most likely, so I would do that, and they can send you for any testing they think is necessary, and if they think you should get in to see the specialist sooner based on their assessment, they can call and do that.

Certainly if things are getting worse, you are vomitting, having behavioral changes, seizures, waking during the night with pain, speech or vision problems, make sure to see someone right away.

Good luck, and keep me posted.

JMK MD

[listers]

Thanks so much for your prompt and thorough response.

I called a couple of other neurologists in the area (New York City has quite the array) and was able to schedule an appointment with another headache specialist for December 12 -- 10 days from now.  I'll definitely pursue something urgently if symptoms worsen, otherwise, I'll hold out the ten days and keep you posted.

Thanks again.