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Intense throbbing pain in head while straining
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Intense throbbing pain in head while straining

For the last two months I have been getting the worst throbbing pain in the top of my head when I strain, laughing, coughing, and having a bowel movement.  It's recently even began to happen when I get up to quickly or turn my head to quickly.  The pain only lasts up to 20 seconds but during those 20 seconds I feel like I am going to die.  It's like an intense painful heartbeat in my head.  Last week I was having a bowel movement and the pain came on so strong that it knocked me off the toilet and on the floor, writhing in pain.  This time it lasted a full 10 minutes.  If I would have had my phone with me, I would have called for an ambulance.  But around 10 minutes and it just stopped and I was fine.  I went to the Urgent Care and was there maybe 5 minutes and they rushed me to the ER.  The Dr was afraid it was an anuerysm.  So I had an MRI and an MRA done.  Both came back clear.  So I followed up with my regular Dr this week and he set me up an appointment with a neurologist.  I am really scared, even though the pain doesn't last long, it is extremely intense and is happening 8-10 times a day.  Does anyone have any experience with anything like this?
15 Comments Post a Comment
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2143641_tn?1396681743
looks like there's a connection with Blood Pressure. maybe not the origin of the problem but the pain must be triggered by sudden changes in BP or vascular problem somewhere.
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Avatar_f_tn
Please don not make yourself scared now. You should worry about if after being thoroughly checked out. Do you have high-blood pressure? It could be that you just need some blood thinners.
The more you worry the worse it may get.
I do but in my case it comes from a problem that only occurs in over 200000 patience or more.
Relax as much as possible . Avoid fatty foods and salt.
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Avatar_f_tn
Nope my blood pressure is great.  80/60 everytime I'm checked.
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2143641_tn?1396681743
if it happens when you get up too quick that makes me think of Orthostatic hypotension.

it doesn't mean that you have a problem with blood pressure but normal changes in blood pressure, vascular pressure are triggering the pain when you get up quick or exert.

did you have other symptoms preceding this problem? loose stool, allergy-like symptoms, pain in ears / face, paresthesia, bladder symptoms?
  
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Avatar_f_tn
Nothing.  This came out of nowhere.  Yesterday I was feeling lightheaded when I stood up and I was scared it was connected.  Then found out the 2 people I live with were feeling the same way so I theno we just have a touch of something.
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2143641_tn?1396681743
interesting, also in my family and friends everyone got sick simultaneously but i seem to be the only one to have notice because they blame different conditions for the symptoms. that's why I asked if there were indirect signs of infection. I'm researching on a possible viral almost asymptomatic flu that is giving unexplained neurological symptoms.
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Avatar_f_tn
The fact that the MRI and MRA came out okay should give you relief that you most likely do not have anything serious going wrong, except for the pain of course.  So I would not worry.

Your blood pressure is great at 80/60??  That's very low on the top number. I am very lightheaded when I do anything when my blood pressure is higher than yours but under 90.  My neurologist would not do my nerve block injections when my top number was 86.  He said it was too low.  And sometiimes even when my blood pressure is under 100, I will have problems.  

I think that you are doing the right thing by seeing a neurologist.  Maybe a prophylactic daily migraine medicine can help you.  Please let me know what the neurologist comes up with for you.

Good luck to you.

Sara
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2143641_tn?1396681743
that's right 80/60 is pretty low for an adult
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Avatar_f_tn
I have always run low. One time it was 50/30.  The Dr couldn't believe I wasn't dizzy or lightheaded.  I felt fine.
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Avatar_f_tn
Well after all these months, I have an answer.  I have a chiari malformation.  I am going for decompression surgery in December.
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2143641_tn?1396681743
Good Luck!
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Avatar_f_tn
Thanks so much for letting us know.  At least you have an answer. Sometimes people have migraines daily with no end in sight.  Wish you the best with your surgery.
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Avatar_f_tn
I have the exact same symptoms…have had them for years. I too, had a MRI and a MRA both came back normal. I have suspected I have CM but no doctor has ever mentioned even the thought that thats what I have. I cant even laugh without the head throbbing pressure. Its in sync with my heartbeat. How were you finally diagnosed with that and do you feel relief after having surgery?
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Avatar_f_tn
Please let us know how your surgery helped your migraines.  I would really like to know.  Hope that it helped.
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Avatar_m_tn
Your headache is what is classified as a "cough headache". It is actually the "only" dangerous headache there is because pretty much all intracranial diseases that give headache, give headaches like this.

That does not mean that your headache is caused by an intracranial disease.
Those who are are called secondary cough headaches and those where no underlying cause is found are called primary cough headaches.

Most cough headaches are primary, that is not dangerous. If you have a secondary one it is most often caused by a Chiari type 1 malformation, followed by spinal csf leak, hydrocephalus, artery dissection, aneurysm,tumors etc.

Since you have had a MRI and MRA that was normal you can rule out almost all causes.

You most likely have a primary cough headache. This one will be treated with a drug called indomethacin.

However, your slightly low blood pressure makes me suspect that you have too high intracranial pressure (not to be confused with blood pressure). This can be tested with a spinal tap where they measure your opening pressure.

If you have too high intracranial pressure then you will most likely suffer from a slight chiari malformation (which only a specialized neurologist can detect) or from idiopathic intracranial hypertension (that does not show on the scans). These conditions are not life threatening. Both can be cured.

Indomethacin and diamox will be the first treatment. If it is a chiari malformation, you can fix it with a surgery if the drugs don't help you enough.

Either way, don't worry.
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