severe head pains

for my whole life i felt this pain in the back of my head. always coming now and agian for about couple minuts each time then trailing off with complete soreness of my scull in the back. sometimes it gets so bad i have to sit down or ill just fall. has happened more than 5 times in a year. passed out before from these pains as well.

now i have a family of my own now and i still have these pains, only getting worse as time progresses, and im very worried, as well as my wife, i really want this to go away. been to doctors at memorial hospital and they say nuthing is wrong just bad headache's. i dont believe this. i want to  but i don't. and the sad part is i just got laid off so i have no money to take care of myself in this situation. is there anything else i can do in my situation. cant keep going back to the hospital just for them to relese me 3 days later with no awnser. this has happened 4 times so far in past. im very clueless and somewhat afraid. dont just want to fall in front of my kids one day or my wife. if i only have a certain time left i would like to know... wouldent you..!

[Neuro Forum]

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 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. Secondary headaches are excluded with imaging such as MRI of the brain and other studies depending on the exact symptoms.

Headaches associated with loss of consciousness, such as you describe, are unusual, and a secondary cause would need to be excluded. There are certain type of heart conditions that can lead to headache (what is termed cephalgic angina) and loss of consciousness, and so a cardiac workup (evaluation of the heart function and heart rhythm) is indicated. A vascular cause, leading to reduced blood flow to the brain, can lead to headache with loss of consciousness. One specific type may lead to pain at the back of the head followed by loss of consciousness; this is known as bowhunter's headaches and results from pressure on the arteries to the brain (the vertebral arteries) during assumption of certain postures. Seizures could lead to headache with loss of consciousness as well, though headache is uncommon with seizures.

If a secondary cause is excluded, then the diagnosis may be primary, but again, a thorough investigation for secondary causes is indicated. Primary headache disorders are much more common than secondary ones. There are several primary headache disorders, over 50 different types.  For example  migraines, which usually a pulsating throbbing one-sided pain with nausea and discomfort in bright lights that lasts several hours. There are other primary headache disorders that are sudden and severe but relatively brief, such as paroxysmal hemicrania, cluster headache, and others. One type of primary headache disorder that can be associated with loss of consciouness is called basilar type migraine.

One type of neurologic disorder associated with headache and loss of consciousness is called glossopharyngeal neuralgia. This typically presents with pain in the back of the throat as well as sometimes the ears, and then there can be loss of consciousness. This is often a treatable condition, with a specific type of nerve block.

Evaluation by a headache specialist (a neurologist specialized in headache medicine) is recommended.

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