can anyone help?

[vtwarren]

10 years ago my husband was out in the woods hunting and all of a sudden got a serve headace.The pain was so bad it brought him to his knees.Since he has had a serve headace that never goes away.It ranges usually from a 3 to a 5 but last Sat. it went to a 10 and has sayed there.He also developed hot and cold flashes,chills so bad he sits and shakes,dizzyness and his leg cramps are getting worse.He is in the hospital right now and they did a spinal tap which was normal except for some blood.They also did a mri which is norm.They don't know what is wrong and he has been to a headace doctor and been on 30 different meds,none that help.I am getting really scared as I am scared that what ever is wrong is getting worse.Can you tell me what test I could ask them to run or if you could give me any advise I would greatly apprecate it.Thankyou,Martha

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

Sorry to hear about your husband's symptoms, but glad the workup so far is normal. There is something called "thunderclap headache," which is described as the worst headache ever that comes on suddenly. Usually when doctors hear about such a headache, immediately we all think of an aneurysm that burst or is about to, causing a very serious brain hemorrhage. However, as recently reported in an article by Dr. Dodick on the subject, other things can cause thunderclap headache, such as pituitary gland problems like a stroke there, tears in the arteries of the neck, blood clots in the veins throughout the brain,vasculitis, and leaks in the cerebrospinal fluid called intracranial hypotension. But what's also very interesting is that it may just be a type of headache in itself with no other serious condition behind it. An MRI and spinal tap are necessary to rule out anything serious. Then, based on the clinical exam and history, further testing may include an MRI of the arteries and veins in your husband's brain called an MRA and MRV to see if there is narrowing or blood clots. Finally, if they suspect vasculitis and the MRA is inconclusive, an angiogram may help as well as routine blood studies.

If everything turns out normal still, then consider a headache specialist at a major academic or clinical center for further evaluation and treatment options. Good luck.