Severe Headaches with Vomiting: Potential Neurological Issues

Q: Severe Headaches with Vomiting: Potential Neurological Issues

Hello： In response to your question. <br>There are many misconceptions about migraines; people often think that pain on one side of the head is a migraine, while pain all over the head is not. <br>This is incorrect. <br>A migraine refers to a type of recurrent vascular headache,

Severe pain accompanied by vomiting?

Since childhood, headaches have been a common occurrence for me, but in the past, I would often wake up after a nap without any pain.
Now that I am 17 years old, the headaches have become increasingly severe.
Recently, each headache has been excruciating and accompanied by vomiting.
Previously, it seemed like I only experienced migraines, but now the pain feels like it is affecting my entire head.
What could be the issue? Is there something wrong with my brain, or could there be a tumor in my brain?

Liang Liang, 10~19 year old female. Ask Date: 2007/12/15

Dr. Huang Yongquan reply Neurology

Hello: In response to your question.
There are many misconceptions about migraines; people often think that pain on one side of the head is a migraine, while pain all over the head is not.
This is incorrect.
A migraine refers to a type of recurrent vascular headache, which is usually unilateral but can also be bilateral.
The standard diagnostic criteria are as follows:
A.
At least 5 attacks that meet criteria B-D
B.
Headache attacks lasting 4-72 hours
C.
Headaches that have at least two of the following characteristics:
1.
Unilateral
2.
Pulsating
3.
Moderate to severe intensity (which can significantly limit or prohibit daily activities)
4.
Aggravation by routine physical activity, such as climbing stairs
D.
During the headache, at least one of the following occurs:
1.
Nausea or vomiting
2.
Photophobia or phonophobia
Based on your description of multiple severe headaches, predominantly unilateral, accompanied by nausea or vomiting, this is characteristic of typical migraines.
Common treatments include analgesics and some preventive medications.
Additionally, adequate sleep and exercise can be beneficial.
Some individuals may find that specific dietary factors can exacerbate or alleviate symptoms, so it may be worth exploring those.
If headaches continue to worsen or are accompanied by weakness or numbness in the limbs, dizziness, blurred vision, or excessive fatigue and drowsiness, further evaluation is necessary.

Reply Date: 2007/12/15

More Info

Severe headaches accompanied by vomiting can be concerning and may indicate underlying neurological issues that require immediate attention. Given your history of headaches since childhood, it's important to differentiate between the types of headaches you are experiencing now and those you had previously.
From your description, it seems that your headaches have evolved from what may have been typical migraines to more severe, generalized head pain that is accompanied by vomiting. This change in the pattern and intensity of your headaches is significant and warrants further investigation.
Headaches can be classified into primary and secondary types. Primary headaches, such as migraines and tension-type headaches, are not caused by any underlying medical condition. Secondary headaches, on the other hand, are symptoms of another health issue, which could range from something benign to more serious conditions like infections, bleeding in the brain, or tumors.

The fact that your headaches are now described as "severe" and are accompanied by vomiting raises a red flag. In particular, the presence of vomiting can indicate increased intracranial pressure, which can occur in conditions such as:
1. Intracranial Hypertension: This condition can be caused by various factors, including tumors, hydrocephalus (accumulation of cerebrospinal fluid), or other mass effects in the brain.

2. Meningitis: An infection of the protective membranes covering the brain and spinal cord can lead to severe headaches, fever, and vomiting.

3. Subarachnoid Hemorrhage: This is bleeding in the space between the brain and the tissues covering it, often presenting as a sudden, severe headache ("thunderclap headache") and can be life-threatening.

4. Brain Tumors: While less common, tumors can cause headaches due to pressure on surrounding structures, leading to pain and associated symptoms like vomiting.

Given your age and the recent escalation in headache severity, it is crucial to seek medical evaluation from a neurologist. They may recommend imaging studies such as a CT scan or MRI of the brain to rule out any serious conditions like tumors or structural abnormalities. Additionally, they may perform a neurological examination to assess your overall brain function and identify any other symptoms that may be present.

In the meantime, keep a headache diary to track the frequency, duration, intensity, and any associated symptoms (like vomiting) of your headaches. This information can be invaluable for your healthcare provider in determining the best course of action.

In summary, while headaches can be common and often benign, the significant change in your headache pattern, especially with the addition of vomiting, necessitates a thorough evaluation to rule out any serious neurological issues. Please prioritize seeing a healthcare professional as soon as possible to address your concerns and receive appropriate care.

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