Left temple headache

[daisyl]

Hello, I am a 28 yr old female, and I've been getting headaches for the past few months. I started getting them in January. I've never had headaches before. It just started one day, around 11am, a throbbing, sharp pain in my left temple, sort of behind the eye, lasted for about 15 min, and went away, and then came again about 2 hrs later, again about 15 min, went away, another few hours, again, etc. This lasted for about a week before I went to my doctor. He checked for a couple of things (sinus, "something serious" which he ruled out after feeling for an artery on the left temple and asking if it hurt, blood pressure) and then referred me to a neurologist specializing in headaches. I went to him and he was pretty thorough with questioning. He had me get an MRI and an MRA, both came back fine. He gave me a prescription for a preventative but I never took it because I wanted to wait a week and see if they would go away first. My dad told me to get my eyes checked, which I had never really done, because I thought I had perfect vision. I went and it turned out I had a slight astygmatism, so I got glasses. I started wearing them every day, even though I didn't have to, and a little less than a week later the headaches went away! I couldn't believe it, I was so happy. About a month and a half or two months has gone by, and the headaches just came back randomly :( They are also a little more intense this time around, and more frequent. I wake up with one (still left side, throbbing), it goes away after 15 min, and then I get one about every 2 to 3 hours all day until I go to bed. It's really irritating. I've read up on cluster headaches and it seems like a match, but I find it odd that the neurologist didn't mention them, and it also seems like people who suffer from them have much worse pain. Mine is more annoying, irritating, not exactly debilitating. Aspirin, Advil, Tylenol, etc do nothing because they don't kick in fast enough, the headache goes away as suddenly as it appears. I'm going to a chiropractor soon to see if an x-ray shows anything, or if an adjustment helps. I just feel like I'm running out of options and wish someone could say "you definitely have this, and this is what you need to do." If someone could respond with some advice I would greatly appreciate it! Thanks.

[Dr Santos]

Hi,
Thanks for the updates. Were there imaging studies such as MRI or CT scan at that time? Post traumatic headache is a common result of head injury and may persists for months or even years after. Aside from headache, other symptoms observed are dizziness, insomnia, difficulties in concentration and mood and personality changes.  This could be due to  muscle contraction of the muscles of the neck and scalp or it can also be due to vascular changes that may give rise to a vascular headache that can pulsate.  Sometimes, these types of headaches present with migraine symptoms.  The accompanying muscle contraction and vascular changes compounded by emotional reactions sometimes produce further anxiety and lead to a viscious cycle. Physical and manipulative medicine including chiropractor consult may also help. Have this checked by your doctor for proper management. Take care and best regards.

[daisyl]

Hi, thanks so much for responding. I'm still clinging to hope that I haven't all of a sudden developed migraines. I'm wondering if there's any connection to a fender bender I got into last summer. I'm pretty sure it caused me to get labrynthitis, which I had for a couple of months following the collision (it was a minor rear-end), and my doctor prescribed motion sickness pills, and it eventually went away. But I never went to an ENT, and I'm wondering if these headaches are a lingering after-effect? Or perhaps I have a pinched nerve or something, because usually when the headaches are subsiding, I have a lot of tension in my neck and shoulder. I'm going to get a chiropractic consultation. After that I might get a dental check-up -- just trying to rule things out. If nothing works, I guess I'll try preventative meds. Thanks again for your help!

[Dr Santos]

Hi,
How are you? It is good that both the MRI and MRA were normal and this means that primary headaches such as cluster and migraine headaches may be considered. Cluster headaches usually respond to oxygen, ergotamine, sumatriptan or intranasal application of local anesthetic agent. Preventive medications such as use of steroids, calcium channel blockers and lithium have been used also. Try to avoid over-the-counter medications because these can lead to rebound headaches as well. Check with your doctor for proper management. Take care and regards.