Headache concerns

Hello, I am a 23 year old male.  I have been having some weird headache for about 5 days.  Thursday afternoon I got up from taking a nap on my couch and my neck was stiff and sore. This has happend before but goes away. So after about 10 minutes my neck is fine.  I play basketball that night, go home and I develop a headache.  Most of the time  my headaches would go away when I layed down and went to bed.  Well the headache was still there friday on the right side of my head but it was a dull more annoying pain. Also back left side of neck muscle also felt still and ached when I had the headache. I take 2 advil and it goes away but I can still feel it when I shake or move my head.  Saturday the dull ache is still there but now on the left side of my head. Sunday it is still there but can only feel it if I move or shake my head.  Sunday around midnight it just goes away by itself.  All day monday no headache and then about 7 pm  I get a breathing problem and take my inhaler and I take a lorazepam since I have anxiety and panic disorder.  Well the breathing is cleared up and then I go to lay down on the couch and when I get up the headache is back but can only feel it if I shake my head up or down and left or right.  Also that night my right eye started to get pain around the brow and felt like behind the eye.  It felt as if someone puts on glasses that doesnt need them and it gives them pain in their eyes.  Well I go to sleep last night wake up and the headache is still there but the eye pain is gone but now its on the left eye. So I take advil again and as I am typing this, my headache and eye pain is gone.  

I had a episode of anxiety and panic attacks back in september and early october and was treated with paxil and lorzepam.  After about a month of taking paxil all the physical symptoms I had with teh anxiety and panic disorder went away and I felt like my normal self again.  I had a ALS fear back then which my anxiety caused me to devlop some ALS symptoms.  

I am just really scared that this could be a brain tumor or aneursym.  

Could my anxiety about the initial headache cause all this?

[Kevin Pho, MD]

Most headaches can be classified as either migraine, tension or cluster headaches.  

The pain of a migraine headache usually begins gradually, intensifies over one or more hours, and resolves gradually at the end of the attack. The headache is typically dull, deep, and steady when mild to moderate; it becomes throbbing or pulsatile when severe. Migraine headaches are worsened by rapid head motion, light, sneezing, straining, constant motion, or physical exertion, thereby leading many migraine sufferers to seek relief by lying down in a darkened, quiet room.

Tension headaches are the most common type of headaches. They are characterized by a feeling of pressure or tightness all around the head. The pain tends to fluctuate during the course of the headache, and the severity of pain and its effects on daily activities vary from person to person. In contrast to migraine headaches, tension headaches occur in the absence of other symptoms such as nausea, vomiting, sensitivity to lights and sounds, or an aura.

The pain of cluster headache begins quickly without any warning and reaches a peak within a few minutes. The headache is usually deep, excruciating, continuous, and explosive in quality, although occasionally it may be pulsatile and throbbing. The pain typically begins in or around the eye or temple; less commonly it starts in the face, neck, ear, or side of the head. The pain is always on one side.  

A referral to a neurologist can be considered for further evaluation.  If you are concerned about a brain tumor, you can consider a head CT as the next step.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

Bibliography:
Bajwa.  Patient information: Causes and diagnosis of headaches.  UptoDate, 2004.