Sudden Severe Head Pain: Causes and Concerns

Sudden severe pain on the right side of the head. Please continue with your questions?

Hello, doctor.
I am the person who asked about "sudden severe pain on the right side of the head" on May 18.
Thank you, Dr.
Gao, for your response.
I would like to continue asking: after my inquiry yesterday, I went to the clinic, and the doctor said it might be due to excessive tension, so they prescribed pain relief and muscle relaxants.
That night, when I went to bed, the headache persisted, and I still felt dizzy and nauseous, with significant pressure in my eyes, making it difficult to sleep.
The next morning (May 19), I woke up with improved headache symptoms, but I still felt tightness on both sides of my head (near the temples).
The right side of my head, which I mentioned yesterday, experiences a throbbing headache with movements like bending over or sneezing (in sync with my pulse).
When I press on the affected area, there is pain that feels superficial, not deep.
I am starting to worry about potential vascular issues in my brain.
Could you please clarify this for me again?

Mr. Zeng, 20~29 year old female. Ask Date: 2015/05/19

Dr. Gao Chunde reply Neurology

There are two common types of headaches.
The first is characterized by tightness in the eyes and head, with tenderness upon applying pressure to the affected area; this is known as tension-type headache.
The second type involves nausea and a throbbing pain that worsens with movement, such as bending over or sneezing, which is indicative of a migraine.
As for cerebrovascular issues, they are typically accompanied by other neurological deficits.

Reply Date: 2015/05/19

More Info

Understanding sudden severe head pain can be a complex issue, as it may stem from various causes, ranging from benign to serious conditions. Based on your description of experiencing sudden and severe pain on the right side of your head, along with symptoms like dizziness, nausea, and a feeling of pressure in your eyes, it is essential to consider several potential causes.

One common cause of sudden severe head pain is tension-type headache (TTH), which can occur due to stress, anxiety, or prolonged periods of poor posture, especially if you spend long hours working at a computer. Tension headaches are often characterized by a feeling of tightness or pressure around the head, which can sometimes lead to discomfort in the temples or the back of the head. The fact that you experienced some relief after taking pain relief and muscle relaxant medications suggests that tension may indeed be a contributing factor.

Another possibility is a migraine, which can present with unilateral (one-sided) pain, often accompanied by nausea, vomiting, and sensitivity to light and sound. Migraines can also be triggered by various factors, including stress, hormonal changes, certain foods, and environmental factors. The pulsating nature of the pain you described, especially when bending over or sneezing, aligns with migraine characteristics.

However, given your concerns about potential vascular issues, it is crucial to rule out more serious conditions such as a cerebral aneurysm or a vascular malformation. These conditions can cause sudden, severe headaches and may be accompanied by other neurological symptoms. If the pain is severe and persistent, or if you experience additional symptoms such as visual disturbances, weakness, or changes in consciousness, it is vital to seek immediate medical attention.

In your case, since the pain is localized and you have noted tenderness upon palpation, it may also be worth considering other causes such as sinusitis, which can cause pressure and pain around the temples and forehead, particularly if you have had recent upper respiratory symptoms. Sinus headaches can be exacerbated by bending over or sudden movements.

To further evaluate your condition, a thorough clinical examination by a healthcare professional is recommended. This may include imaging studies such as a CT scan or MRI to assess for any structural abnormalities or vascular issues. Additionally, blood tests may be conducted to check for signs of infection or inflammation.

In the meantime, managing stress through relaxation techniques, regular physical activity, and maintaining a proper ergonomic setup while working can help alleviate tension headaches. Staying hydrated and ensuring adequate sleep are also essential for overall health and may help reduce the frequency and severity of headaches.

If your symptoms persist or worsen, or if you develop new symptoms, it is crucial to follow up with a neurologist or a headache specialist who can provide a comprehensive evaluation and tailored treatment plan. Remember, while many headaches are benign, it is always better to err on the side of caution when it comes to sudden and severe head pain.

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