Horrible unilateral headaches

[JessicaLynn]

So like two months ago I went to a neurologist about headaches I have been having.

Description of headaches: always on right side, around top of eye and temple area. I always (24/7) have a low throbbing in that area. Then during the day (at night I’m also woken up) I get horrible headaches, that come on slow or fast, and is a sharp stabbing pain in that area that can last from a couple of hours to a couple of min. They get worse if when having one I bend over to pick some thing up off the ground. I have these headaches multiple times a day (I counted 11 in just one day) My average seems to be 5-6 though. (I'm female and 18) These headaches started in Oct. they came on slowly though, only a few a week and then got more frequent. The last 4 months have been as described.

1st visit to Neurologist: Stop taking all OTC pain killers She prescribed Nortriptyline starting at 10mg and raising it by 10mg every 4-7 days if it wasn’t working. She also had me keep a headache diary.

2nd visit to Neurologist a month later: Up to 50mg of Nortriptyline, with no results. I have not taken ANY OTCs since she told me to stop. She was shocked when she saw my headache diary(from the # of them and because there was not one day without a headache). She took blood to test, she tested: blood iron levels, thyroid, and hormonal levels. All normal. She also ordered a MRI. The MRI showed an arachnoid cyst in the spot where my cerebellum meets my brain. I was told that the cyst is not causing my headaches.

I was then told my right pupil was larger than my left one. I was given a new prescription for 75mg. of nortriptyline, which (after 2 weeks) is not working the slightest.

The cyst is being watched with another MRI in 6 months. But could the cyst be causing my headaches?
What about my pupils? Am I just abnormal?
I’ve been told my headaches are tension headaches, but everything I read about tension headaches does not sound at all like my headaches.
Any suggestions?

[CCF-Neuro-M.D.-PW]

I cannot give you a formal medical opinion over the internet unfortunately as this site is purely educational.

Arachnoid cysts are usually an incidental finding and are quite common in that location, and are not asscoaited with sympttoms. You clearly have a form of chronic daily headache - a more recently described form o fthis is chronic migraine (initially thought of as only being 'acute'). The management of these headaches is more diffccult, but you are have done the right thing in coming off the OTCs. After a few weeks off the OTCs, te prescribed treatent are more likely to work. Breaking the daily headaches may be difficult also and sometimes needs inpatient admission for medications like DHE and IV steroids.

A certain degree of asymmetry of pupils (about 0.5mm) is normal and is called 'anisocoria'

Good luck

[JessicaLynn]

Thanks for the help.

I have been off the OTCs since April 24. Which kind of concerns me becuase it's been so long, and still no relif. Well, just a week more...my next appt. is on June 6.

[FI mom]

i am a concerned mom with a 16 year old daughter with daily headaches also.
she was in an accident at the end of October. she was Tboned and the driver. the boy hit her at approx 35 mph without breaking. the airbags hit after he drug her. she was knocked out, and now has trouble with her lower back (lower back sprain) and headaches (primarily frontal, and base of skull & sometimes on top of her head)... (post concussion syndrome), vertigo, and trouble sleeping and difficulty concentrating in class and taking notes because of her neck strain. curvature in her neck is now straight.
she has seen a chiro for approx 6 month. she says it hurts and makes her nauseas. she does not get relief. she stopped about 2mos. ago. things are not better and the sleeplessness is worse. she had a eeg,open mri and xrays. all normal.
what can be done for the headaches?
sleeplessness?
lower back weakness?
neck strain and curvature?

[jcverive]

I'm so sorry to hear about your child's pain.  The headaches you describe sound like cervicogenic headaches, which means they are caused by a problem with the spine in the head or neck region.  Several sensory nerves for the scalp originate in the dorsal (rear portion) of the first few vertebrae, notably C1-C3. Damage, compression, or any trauma to these nerves can cause a great deal of pain, even if the trauma happened a long time ago.

It's important to understand that the trauma need not be severe in order to cause severe pain, so "clear", "negative", or "unremarkable"  MRI and/or CT tests do not rule out the minor trauma that often causes tremendous pain.

I recommend that you see a good pain doctor in a pain clinic setting. Other specialists are frequently untrained to provide proper care.