sharp stabbing head pain

Any time I cough, laugh hard, have a BM (TMI) play hard with the kids I get this sharp pain in my head temples and in the back of my head.  It actually feels if my head is about to pop. 10 out of 10 pain.  I have to stop what i am doing and  i grab my head.  it will last about 30 secs.  My husband says my face turns almost dark red almost purple and it scares him.  I told my doc about it and all she said is it related to my smoking.  I am 30 years old not much of medically history except a leioma tumor when I was two.  I take no medication.  Over weight but otherwise healthy.  any ideas of what could be going on?????

[Phtartist]

How is your blood pressure?

[sjjohnso]

I have alway had good blood pressure every time it is checked it is 120s over 70s

[Dr Sharma]

Hi there. These headaches could be due to stress, anxiety, migraines or tension headaches, sinus headaches radiating to the ear, headache usually front of head, on one or both  the sides of temples along with nausea, vomiting, irritability, low blood pressure, sensitivity to lights, sound, etc. aura associated with migraines could include blind spots, blindness in half of your visual field, paresthesia, weakness or visual hallucinations. Your vision needs detailed testing by an ophthalmologist. Hypertension and hypotension need to be checked. An MRI brain is warranted to rule out any intracranial lesion particularly aneurysm and MRI spine for ruling out cervical spondylosis and degenerative disc disease.  Temporal tendinitis mimics migraines including TMJ pain temporal headaches, tooth sensitivity, neck and shoulder pain. Treatment includes injecting local anesthetics and other medicines, moist heat muscle relaxants and NSAIDs along with physiotherapy. Multiple sclerosis would also need to be excluded. Treatment for migraines include drugs that prevent the attack like anti convulsants and drugs which treat an attack like triptans, ergots etc your queries should pertain to all these possible differential diagnoses. Trigeminal neuralgia needs to be considered. If the neurologist and radiologist are suspecting a cerebral aneurysm, they can confirm with cerebral angiography and clipping of the aneurysm could be done. Hope this helps. Take care.