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sharp, shooting headaches
For the past 6 years I have been getting these terrible sharp, shooting headaches in the back left part of my head.  They feel like a lightning bolt through my brain, extremely severe pain, but they only last for a couple seconds and then they are gone.  For those 2 seconds I just have to shut my eyes and grit my teeth with the pain.  The pain is always located in the exact same place in my head.  I've tracked my symptoms and there doesnt seem to be any specific triggers.  I have had MRIs and CT scans with no results.  The only other diagnosed medical condition I have is a herniated disc in my C4-C5 vertebrae and chronic rhomboid pain that results from it.  I also have a strange undiaganosed heat-sensitive peripheral neuropathy that responds to nerve pain meds.  Could these all be related?

Any insights you have to offer would be greatly appreciated!
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Hi,
These headaches could be neuralgias (nerve pain) or they could be icepick headache. Icepick headaches are sharp shooting pain that last for few seconds and characteristically recur. Indomethacin is usually prescribed for icepick headaches which are very common in migraineurs. Please consult a neurologist at the earliest so that a definitive diagnosis can be made.
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The symptoms you described are typical of cervicogenic headache, particularly involving the occipital nerve.  Sharp, shooting, and localiized scalp pain in the back of your head is almost certain to involve the occipital nerve, and a previously diagnosed medical condition involving the cervical vertebrae suggests compression or other trauma to the occipital nerve (or C2 ganglion nerve root).

A neurologist should be able to help you, though many people I've talked to share my experience that a good pain clinic doctor is more likely to be able to treat you successfully. This is probably due to the much greater amount of experience that most pain clinicians have treating difficult pain syndromes.

Good luck! - Jeff
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348314 tn?1358018113
Can any one explain this headache,,,when ever I cough ,sneeze , or have a sharp movement, I get a headache in the back or my head, it feels like my head is about to explode, for about 10 secconds, the only way I can get through them, is to take deep breaths, it is very scary when I'am driving.I just had an MRI done but have not gotten the result back yet. what could it be.
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Since coughing and sneezing often create "whiplash-like" movements in the head and neck, it is very likely that you are compressing, pinching, or otherwise causing trauma to scalp nerves or nerve roots (based on your description, C2 and/or C3 are likely candidates). Be advised that MRIs, CTs, and other imaging tools have limited resolution, and therefore cannot spot lesions or other nerve injuries that are smaller than a few tenths of a millimeter, yet such nerve trauma can result in severe, debilitating  nerve pain. A "clear" or "unremarkable" MRI or CT only rules out lesions larger than the minimum resolution of the particular device. Other techniques (such as diagnostic nerve blocks, nerve conduction studies, and EMGs) must be used to locate small regions of nerve trauma, and even these tools are not always 100% reliable. A skilled doctor with years of experience locating small nerve lesions will improve your odds of finding the origin of your pain, but in some cases treatment must be started without the offending location ever being found.  Nevertheless, I wish you great success in identifying both the cause and an effective treatment for your pain.
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348314 tn?1358018113
I got the test result back today, and my Dr told me I have a condition called Chiari Malformation, type I, It is some kind of defect in the cerebellum, right now I'am just taking it all in, so I'am going to do some research on this condition, to find out everything I can.  If you have any input on this please pass it on.


thanks
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A chiari malformation, also called an Arnold Chiari Malformation. is a condition in which the lower portion of the brain "sags" or "dips" below the top of the spine through an opening in the top of the spine called the "foramen magnum" (latin for "big hole"). When this occurs, the brain matter can compress nerves in the upper (cervical) vertebrae.  Since these nerves contain the scalp nerves, scalp pain - especially at the base of the skull - is very common.

A neurologist and/or neurosurgeon will be able to explain the procedures available to correct the condition or to handle the nerve trauma.

Best of luck - Jeff.
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348314 tn?1358018113
Thanks for the information.  I will keep you posted.


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348314 tn?1358018113
The protrusion is 13mm in the foramen magnum is that really serious, I have a appt 1-4-08 to see a neurologist
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