Pulsating localized headache

I have a pulsating severe headache centered mid forehead above my left eye. I have no motor impairment or mental impairment. I can't get a night's sleep even with sleep meds. This started three days ago. I went to emergency room and had a negative CT scan. Since onset the headache is more localized. I haven't had this kind of headache before. I'm a 79 year old male and physically active. Two mornings ago I ran two miles at about 16 minutes per mile. I have run two 5Ks this winter with no ill effects. My head loosens up when I run and it did so after the run two mornings ago. I get a euphoric feeling from running. I wonder if my headache is a leftover from that two mile run. The head loosening after it seemed a bit more pronounced than usual. From on line research I'm convinced that my headache is not sinus or migraine.

[J.M. Keyes, MD]

Hi there,
The fact that you have had a negative CT scan is reassuring.  I don't about what other symptoms you may be having, what other tests may have been done in the ER, what type of CT scan you had etc., so I cannot tell you with great certaintly what is going on.
However, a severe, unresolving headache, brought on by physical activity, in your age group is quite worrisome to me.  Some intracranial bleeds are missed on CT, and need a lumbar puncture for diagnosis.  The liklihood is probably low, but because the result is so catastrophic, it needs to be considered.  I would follow up with your physician for further exam/potential testing as soon as possible.  If things worsen you need to  return to the emergency department.

Good luck,
JMK MD