Pulsating Pain in the Back of the Head After Bathroom Visits - Neurology

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Pulsating pain in the back of the head, especially after activities such as using the bathroom or engaging in sexual activity, can be concerning and warrants further investigation. Based on your description, it seems that you have experienced this type of pain intermittently for several years, alongside a history of mild pressure-like sensations in your head. Additionally, you have undergone a strabismus surgery, which has led to complications such as diplopia (double vision) due to fourth cranial nerve palsy.

The pulsating pain you describe could be related to several factors. One possibility is that it may be a form of exertional headache, which can occur during or after physical exertion, including activities that increase intra-abdominal pressure, such as straining during bowel movements or sexual activity. This type of headache is typically benign but can be quite uncomfortable.
Another consideration is the potential for vascular issues. The pulsating nature of your pain suggests that it could be related to blood flow or vascular changes in the brain. Conditions such as migraines can also present with pulsating pain and may be triggered by various factors, including physical exertion, stress, or changes in blood pressure. Given that you have noted fluctuations in your blood pressure, it might be worth exploring whether these changes correlate with your headache episodes.

Since you have already undergone a magnetic resonance imaging (MRI) scan of your brain, which returned normal results, it is less likely that there is a structural issue causing your symptoms. However, if the headaches persist or worsen, it may be prudent to consult with a neurologist who specializes in headache disorders. They can provide a more comprehensive evaluation and may recommend additional tests, such as a CT scan or further blood pressure monitoring, to rule out any underlying vascular issues.

In addition to seeking further medical advice, consider keeping a headache diary. Documenting the frequency, duration, intensity, and potential triggers of your headaches can provide valuable information to your healthcare provider. This can help in identifying patterns and potential causes, leading to more targeted treatment options.

Furthermore, since you mentioned experiencing double vision and other visual disturbances following your eye surgery, it may also be beneficial to consult with an ophthalmologist or a neuro-ophthalmologist. They can evaluate whether there is any connection between your visual symptoms and the headaches you are experiencing.

In summary, while your pulsating headache may be benign, it is essential to monitor your symptoms closely and seek further evaluation from a neurologist or appropriate specialist. They can help determine the underlying cause of your headaches and recommend effective management strategies. Additionally, managing your overall health, including maintaining stable blood pressure and addressing any stressors, may also contribute to alleviating your symptoms.