4 month long headache

I have had a non-stop headache for 4 months now.  It never stops.  Instead the pain level varies between barely manageable to being so extreme I have to hide in a quiet dark closet away from everyone.  I've been to my primary care physician and to a neurologist.  They've tried numerous medications and I've had both MRI's and MRA's.  The scans did find 2 very small aneurysms but the neurologist said that they are too small to be causing the headaches.  As of now they have no idea why I am getting the headaches.  Blood tests have all come back negative.  I am not having any sinus congestion.  The pain feels like a giant ring around my head squeezing my head and crushing it with spikes pointing inward piercing deep into the skull at my eyes, temples, & at places in the back of my head.  The headaches are so bad I have had to miss work.  This is completely ruining my life.  Please help.  Any ideas on what could possibly be causing this?  

[911sufferer]

I forgot to mention that I also keep seeing bright lights that get worse when the headaches are at their most painful and don't go away if I close my eyes.

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
Since you have a headache almost daily, what you have is in all probability not a simple migraine but a chronic daily headache (CDH). This can be the primary type—without any cause. One simple reason for daily headaches with nausea is compression of cervical spinal nerves. Another reason is TMJ, especially if the headache starts with chewing. The third reason could be severe acidity with or without GERD. The CDH could also be secondary to trauma, raised intracranial hypertension, high blood pressure, temporal arteritis etc. Hence all these need to be ruled out.  If the headache lasts for less than 4 hours then it could be a chronic cluster headache or a chronic paroxysmal hemicranias. If it lasts for more than 4 hours it could be chronic tension headache, chronic migraine or altered migraine or hemicranias continua. Indomethacin is the drug of choice in hemicranias continua. In fact the diagnosis is considered confirmed if a patient responds to Indomethacin. Since a confirmed diagnosis cannot be given on net please discuss these possibilities with your doctor once. You may need some tests for confirmed diagnosis which may include blood tests, MRI etc. Take care!

[911sufferer]

I'll suggest the Indomethacin when I see the neurologist next.  We've done MRIs already and found nothing except 2 very small aneurysm in the brain stem.  The headaches are the most painful things I've ever experienced, move around the head, but are continuous, moving around all day and all night.  The pain feels just like what I've since read about cluster headaches but the duration is nowhere near short enough.  It's like a cluster headache on steroids.  This is is the pure definition of hell.  Spikes being driven through my skull 24 hours a day, 7 days a week, for the past 4 months, with no end in sight.  God willing that drug will have an effect.