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Severe Headaches/Knots on Head/Left Side Numbness
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Severe Headaches/Knots on Head/Left Side Numbness

My husband is 40 yrs old and for the past month he has said that he has been having numbness on the left side of his body from his neck down his left arm. 3 wks ago a pea size hard, painless knot  came up on the right side of his head.  Last week it had grown to the size of a quarter & is raised about 1/4", & multiple pea size knots surrounding it has popped up.  I checked it again this Monday because he had an episode where he slumped forward in the recliner & was unable to speak for about 5 minutes.  The knot now has a "tail" to it growing toward the front of his head about 2" long & raised about 1/4" high still w/ multiple ones popping up around it. Knots are not painful but he is now having severe headaches.  W/ this episode, he finally responded to me & got up & splashed cool water on his face & said he was "fine".  I checked his heart rate, I would get 7 -8 strong heartbearts, then they would go very faint for 4-5 heartbeats & start right back to strong.  He was very pale.Then last night he woke @ 1 a.m. moaning very loudly & sit up on the side of the bed holding his head in severe pain for 45 minutes before he got out of bed & went to the recliner.  He constanstly complains of indigestion & acid reflux.  He won't tell me about alot of his episodes because he doesn't want me to worry, I only know if they happen at home or he slips up and tells me they happen at work.  I know there has to be something seriously wrong with him to have:
1. Severe Headaches 2.Growing Knots on his head 3 Numbness on left side of his body 4.Constant indigestion & acid reflux. 5.Heavy Nose Bleeds
Can anyone tell me what may be going on with him.  I have begged him to go to the Dr. but all I get is that he doesn't have time to take off work.  He has admitted the he thinks he is having TIA's.  We know he has high blood pressure and high chloleserol but has never been given medication since he was diagnosed with that when he had a Bell's Palsy Stroke when he was 28.  Please Help!!!!
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Headaches can be a primary headache (such as a migraine) or secondary headache (such as from a structural lesion in the brain). One type of headache in the posterior part of the head is a cervicogenic headache. This headache is "referred" to the head from bony structures, muscles, and other soft tissue in the neck and shoulders. Symptoms are usually one-sided and include: precipitation of head pain by neck movement or awkward neck positions, head pain when external pressure is applied to the neck or occipital region, restricted range of motion of the neck, and neck, shoulder and arm pain. Treatment for cervicogenic headache includes physical therapy, medications.

Another type is occipital neuralgia. This headache is caused by irritation or injury to two nerves that run from the upper neck to the back of the head. The irritation could be due to neck trauma, pinching of the nerves (by muscles or arthritis), and other causes. Symptoms include a piercing sharp pain that travels from the upper neck to the back of the head and behind the ears. It is usually a one sided pain but can be on both sides of the head. Treatment includes physical therapy, medications, and in some cases injections, "nerve blocks", during which a physician injects the irritated nerves with an anesthetic.

A concerning cause of neck pain associated with headache is a dissection: a small tear in the blood vessels that travel up the neck to the brain. This can occur spontaneously in people with certain conditions that affect the blood vessels, after neck trauma, or after chiropractic manipulation of the neck. The pain is often but not always associated with some sort of neurologic deficit as a dissection can often lead to a stroke. A dissection is diagnosed with a specific type of MRI test (MRA with fat saturation) or an CT angiogram.

I also mentioned that structural lesions (such as a mass) can cause posterior headaches. This may be relevant given the “knot” that has occurred. Where exactly is the “knot” located? It may represent a lipoma (benign tumor) or lymph node enlargement. He will need to have this evaluated for possibilities. Both could cause headaches. Additionally, a herniated disc in the neck could cause his symptoms as well which would be evaluated with the neck MRI.

I agree your husband should be evaluated. He may need to have imaging of his head and neck (with an MRI) to determine if there is a structural cause for the headaches. Other diagnostic testing (such as a spinal tap) may or may not be necessary at the discretion of treating physician.  

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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