constant headache

My grandmother is 80 years old and a few months ago suffered a case of unconsciousness. She is not in US and the medical attention back where she is, is terrible. The doctors could not figure out what she had. She started out with horrible headaches day in day out. Everyday for a few weeks and then one day after she woke up, she was unconscious, not being able to talk and was just moaning. We took her to doctors to figure out what she had with no luck, fed her, took care of her and after a few weeks of the unknown she finally began to gain consciousness.

Today she told us that her headaches are back. Every since she wakes up and last all day long around her forehead. I am afraid that the past event might happen again. I would like to avoid it and at least know what she has. I read about elderly patients with nerve tone problems in their legs suffering from not getting enough blood into the brain. Can this be the cause of this? What can she do, massage her legs? Painkillers don't help at all, and she is miserable.

I know that when she had her first incident, the doctors prescribed "kovinton" a medication that I cannot seem to find anywhere in the US. Yet I'm not sure if its the drug injections that helped her, or time... I want to help her now.

please if anyone has any idea of what she has, please let me know and if anyone has similar symptoms please tell me how you manage it.

Thank you.

[Christopher R Newey, DO]

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.

The headache your relative is having is not particularly a primary headache (such as a migraine) from your description. The concern would be a secondary headache. Secondary headache disorders are due to an underlying problem, there are many many causes but some include medication side effects, systemic illness, nervous system infection, tumors, bleeds in the brain or clots in the veins of the brain, and others.

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 but some include:
-Tumor
-medication side effects
-central nervous system infections (meningitis)
-CNS vasculitis (which often shows up on MRI but sometimes requires an angiogram and lumbar puncture for diagnosis)
-neck problems (as in cervicogenic headache which causes predominantly pain at the back of the head)
-bleeds in the brain
-clots in the veins in the brain (called venous sinus thrombosis, best diagnosed with a test called MRV. Risk factors include the use of oral contraceptives and blood conditions in which the blood is prone to clotting, called hypercoaguable state)
-benign intracranial hypertension (due to elevated pressure in the fluid around the brain called CSF, suggested by the presence of papilledema, or optic nerve swelling in the eye as diagnosed by an eye doctor, commonly occurs in overweight people or those taking specific medications, and best diagnosed by lumbar puncture)  etc.
-intracranial hypotension (too little fluid around the brain, as occurs following surgery or lumbar puncture or less commonly spontaneously. Suggested by the headache improving when a person lies down and worsens with sitting up)

I highly suggest that your relative follow up with a physician. She should have at the least a scan of her head, especially an MRI. I would also look at her vasculature of the head and neck. Lastly, she should have her heart evaluated with an echo.

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