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Unilateral Headache
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Unilateral Headache

I am a 20 year old female and I have suffered from unilateral headaches for as long as I can remember. The headaches are always the same: the pain is on the front, right side of my head, covering about a palm sized area, with pain radiating around and behind my right eye and temple. The pain in the eye is dull (reminds me of an "ice cream headache"), and the headache itself is steady but not excruciating, usually comes on in the evening, and usually is resolved by aspirin or cold compresses, or sometimes by applying pressure to the area. I also experience daily pressure around my right eye and behind my right ear, with occasional "wooshing sounds" in the ear. I've also noticed that for a few months now the right eyelid is drooping slightly. A quick search on this site has me worried that these symptoms suggest something serious like a tumor, aneurysm, or an AVM. My GP has told me that I have slightly high blood pressure, but no bruits and he doesn't think an appointment with a neurologist is necessary. I don't have any other symptoms associated with neurological disorders, but should I be concerned?
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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.

There are several causes of headaches. Headaches can be divided into primary and secondary. Primary headache disorders are headaches without a direct cause. These are diagnosed after secondary causes have been excluded. Secondary headache disorders are due to an underlying problem, there are many many causes, as you have seen on the Internet.
I mention secondary headaches only because you are concerned about the whooshing sound in your ear. This may be related to the inner ear and structures, vascular malformation(s) as you mentioned, anxiety, etc.

I see that you have posted your unilateral headache symptoms in several forums and one responder mentioned migraines. I won’t discuss this much other than migraines are usually pulsating, one-sided pain with nausea and/or vomiting, and can have light and sound sensitivities. There are other types of primary headaches including cluster headaches, which are sharp pains that occur around and behind the eye often at night and are associated with tearing of the eye and running of the nose. Yet another primary headache is a primary stabbing headache which is a sharp or jabbing pain in the head, either as a single stab or a series of brief repeated volleys of pain. Many people will describe this pain as an ice-pick. Primary stabbing headache often occurs in people with migraine. These pains are usually less than a fraction of a second but can last for up to one minute in some people. Another type of stabbing headache is called paroxysmal hemicrania. This is marked by episodes of stabbing or sharp pains that occur on one side of the head and may be associated with eye tearing or runny nose. Episodes may occur several times and last 30 seconds to a minute. Yet another type of stabbing headache is abbreviated SUNCT; 100s of stabbing pains lasting seconds occur and are associated with red eye and tearing.

Without further information about your headache, it is difficult to provide you with adequate information. However, it is important for you to understand that if you have not experienced headaches in the past and you are now having new head pains, seeing a neurologist is a good idea, just to make sure there is nothing serious causing this pain. Imaging of the brain may be indicated depending on your exact symptoms, your physical examination, and other factors. It is important that you have a thorough neurological examination to ensure no deficits. This may require a referral to a neurologist who specializes in headaches.

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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