Severe Headaches After High Fever: Causes and Solutions

Throbbing headache?

Hello Doctor: Since early Saturday morning (April 19) at 2:00 AM, I have been experiencing a high fever (39.3°C), which rose to 40.3°C by 3:45 AM.
By 10:00 AM, my temperature dropped to 38.3°C, and I went to a major hospital's ENT department due to severe throat pain and difficulty swallowing.
In the clinic, my ear temperature was measured again at 39.3°C, and the fever finally subsided after 5:00 PM.

Since the onset of the high fever at 2:00 AM on April 19, I have also experienced a heavy-headed feeling and intense headaches.
Even after the fever broke, the severe headache persisted.
No matter how I lie down and rest, the pain does not alleviate.
Additionally, my eyes sometimes water, and I occasionally experience blurred vision.
The pain is located at the top of my head, on both sides of my temples, and behind both eyes.
I have taken pain relievers, which only slightly reduce the pain, but once the medication wears off, the pain returns with a vengeance, causing me to grip my hair tightly and even punch the painful areas on my head.

What should I do to alleviate this unbearable pain?

Jia Jia, 20~29 year old female. Ask Date: 2015/04/21

Dr. Gao Chunde reply Neurology

Severe headaches persisting for three days, whether due to central nervous system infections, cluster headaches, or other specific causes, should be re-evaluated by a healthcare professional to address the headache issue properly.
If there is still no improvement, it is advisable to seek an appointment with a neurologist as soon as possible.

Reply Date: 2015/04/21

More Info

Severe headaches following a high fever can be distressing and may indicate several underlying issues. Based on your description, it appears that you experienced a significant fever, which peaked at 40.3 degrees Celsius, accompanied by severe headaches and other symptoms such as a sore throat and difficulty swallowing. After the fever subsided, you continued to experience persistent and intense headaches, which have not improved with over-the-counter pain medications.

Potential Causes of Your Symptoms
1. Post-Viral Headaches: After a viral infection, it is common for some individuals to experience lingering headaches. This can be due to inflammation or irritation of the meninges (the protective membranes covering the brain and spinal cord) or other neurological structures.

2. Sinusitis: Given your initial symptoms of a sore throat and fever, it is possible that you may have developed sinusitis, which can cause headaches, particularly in the forehead, cheeks, and around the eyes. The pressure from inflamed sinuses can lead to significant discomfort.

3. Migraine: The description of your headaches, especially if they are unilateral (on one side) and associated with symptoms like tearing or visual disturbances, could suggest a migraine. Migraines can be triggered by various factors, including stress, hormonal changes, and even post-viral states.

4. Tension-Type Headaches: Stress and discomfort from being ill can lead to tension-type headaches, characterized by a feeling of tightness or pressure around the head.

5. Meningitis: Although less common, severe headaches following a high fever can be a sign of meningitis, an infection of the protective membranes covering the brain and spinal cord. Symptoms may include a stiff neck, sensitivity to light, and altered mental status.

6. Other Neurological Conditions: Given the severity and persistence of your headaches, it is essential to rule out other neurological conditions, such as intracranial hypertension or other serious complications.

Recommendations for Management
1. Seek Medical Attention: Given the severity and persistence of your headaches, it is crucial to consult a healthcare professional, preferably a neurologist. They may recommend imaging studies such as a CT scan or MRI to rule out any serious conditions.

2. Pain Management: While over-the-counter medications like acetaminophen or ibuprofen can help, they may not be sufficient for severe headaches. Your doctor may prescribe stronger medications or recommend preventive treatments if migraines are diagnosed.

3. Hydration and Rest: Ensure you are well-hydrated, as dehydration can exacerbate headaches. Adequate rest is also essential for recovery.

4. Monitor Symptoms: Keep a headache diary to track the frequency, duration, and intensity of your headaches, as well as any associated symptoms. This information can be valuable for your healthcare provider.

5. Consider Lifestyle Modifications: If stress or tension is a contributing factor, consider relaxation techniques such as yoga, meditation, or deep-breathing exercises. Regular physical activity and a balanced diet can also support overall health.

6. Follow-Up Care: If your symptoms persist or worsen, follow up with your healthcare provider. They may consider further evaluations or referrals to specialists.

Conclusion
Severe headaches following a high fever can arise from various causes, including post-viral effects, sinusitis, migraines, or more serious conditions. It is essential to seek medical evaluation to determine the underlying cause and appropriate treatment. In the meantime, focus on hydration, rest, and monitoring your symptoms closely. Your health and well-being are paramount, and addressing these headaches with professional guidance will help you find relief.

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