Severe Headache at the back and top center of my head

[mgerm05]

SInce the 1st week of August this year I have been experiencing this severe pain at the back of my head and sometimes at the top center.  This pain is severe at times where I have actually gone to the ER twice because of it.  Unfortunatley they just treated me with a painkiller cocktail and advised to follow up with my PCP.  My PCP seems to think that it is related to Migraines since I have had these in the past but he is not hearing me when I tell him the pains are more intense than a migraine.  I have taken several OTC medications as well as prescriptions and nothing is touching the pain, He won't refer me to a Neurologist which I feel I really should be seeing.  Does anyone have any suggestions as to what might be causing this pain?

[Dr Santos]

Hi,
How are you? If there is no previous history of trauma to the head or neck, this could indeed be due to primary headaches such as migraine. However, imaging studies and referral to a neurologist will help with the diagnosis. Try to avoid OTC pain medications also to avoid rebound headaches. If this is migraine, both acute and preventive medications may help. Take care and regards.

[sara12345]

You are right.   You really need to see a neurologist with pain that bad.  Keep pressing your doctor.  I assume that you need your doctor's referral.  The doctors know that if they make too many referrals that they get dropped as a physician by the insurance company.

If you don't need a referral, make the appointment yourself to see a neurologist.

You should at least be trying a prophylactic medication that you take every day to avoid the headaches, instead of risking rebound headaches from taking the pain killers (even OTC ones).

My migraines are worse than yours are, so it could indeed be migraines, but that's no excuse for not pursuing more care.  My physician (now fired by me) just gave me pain killers when I had exceptionally terrible migraines that I had never had before, even though I had a long history of migraines.  Three weeks later I had a carotid artery dissection stroke which my current neurologist thinks my severe migraines were the start of the stroke.   It's been too long for you to have such a situation, but there is literature that says that migraines can bring on strokes.

And my first neurologist after the stroke just put me on an opiate pain killer (Lorcet) 24/7 plus Tramadol.  What an absolute idiot!!!  I fired him too after 8 months when I saw a better neurologist, because the pain killers were just perpetuating the migraines.  Plus opiate pain pills are very addictive and when it came time for me to have an endoscopy to check for pre-cancer in my esophagus, the doctor had to put it off because she didn't think I would respond to the anesthesia after being on the opiates!!  I had to wait months after stopping the pain killers.  What if I had been in a car accident?  

So make sure you get an adequate neurologist.  It sounds like you may have an occipital migraine.  The good neurologist gave me nerve block injections which made the headache go away completely the first week afterwards.   I'm still getting them.  Plus there are other treatments that have helped me other than pain killer pills.  

I'm tremendously better now with all the treatments, but I still have to go to the ER about once a month and still have some kind of headache 24/7.

So let me know how you are doing and I'm happy to share more treatments with you.  Take care.

[tammie250]

Migrane, headaches are the worst but I am not a doctor so it is best you ask your Dr. this! the headache sounds serious enough that I can not help sorry yours trulyTammie250