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Ask Anthony Bray, MD Your Own Question

Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6661
Experience:  14 years as clinician in the field of Family Practice
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I have daily headaches in the top of my head. I had a CAT

Customer Question

I have daily headaches in the top of my head. I had a CAT Scan and MRI they both showed normal. I was seen by (2) neurologists they both said it's in the mold of my head that never closed up. One doctor prescribed medication that made me sick. I hade to go to the emergency room. I don't believe headaches are normal. Can you please help.
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD :

Hello!

Anthony Bray MD :

If you had a suture line that failed to close I would not expect that to cause headaches really...

Anthony Bray MD :

When do your headaches occur?

Anthony Bray MD :

What quality of pain do you have >> dull ache, throbbing, sharp or other??

Anthony Bray MD :

Do you have headaches when you first wake up?

Anthony Bray MD :

How long have these headaches been going on??

Anthony Bray MD :

Do you have headaches that more come on during the middle of the day onward?

Anthony Bray MD :

Are you under much stress or do you feel that you have much stress or anxiety??

Anthony Bray MD :

Do you have nausea with your headaches?

Anthony Bray MD :

Is there anything that tends to trigger the headaches as far as you can tell??

Anthony Bray MD :

If you can provide the above information then I will return to you later today....

Anthony Bray MD :

Anthony Bray MD

Customer :

My headache usually occur around 4:00am in the morning , the pain is sharp & throbbing, Yes the pain usually wake me up. These headaches began around a year or more ago. I may skeep a day or so and then it's back again. No the headache usually start in the morning and when I take a pain killer like Ibuprofen, I take three it subsides. One doctor prescribed Tramadol HCL50 mg and I had to go to the emergency for and was given intervence and a prescription for nausea. I have had headaches to come on during the day, but mainly in the early mornings. Like I said before I had a CAT Scan and MR

Customer :

Like I said before I had a CAT Scan and MRI before both were normal. One doctor said the MRI did show some small black dots on my brain which were normal for someone of my age (71). If I am depressed I don't know what I'm depressed about. Please help me.

Anthony Bray MD :

Most of the time with headaches an MRI or head CT will not reveal the cause.....

Anthony Bray MD :

The throbbing characteristic and the nausea are sounding like a vascular type of headache. One type of vascular headache is of course migraine type headache. Have you had a past history of migraines?? One thing that does not seem to fit well with the migraine theory is that migraines are LESS likely to occur as you age but can occur at almost any age...

Anthony Bray MD :

Migraines usually do not start until puberty and they most typically reduce in frequency as people get older. It could be that you have some new trigger for migraine type headaches....

Anthony Bray MD :

So one potential stategy that might be of possible help would be to try a migraine preventative >> these tend to reduce the frequency of migraines when taken daily. I prefer either Topamax, Elavil or Inderal as a preventative. Your doctor might consider a month trial to see if this helped to reduce the frequency of the headaches. Keep in mind that a preventative does NOT stop all headches but if your frequency was reduced by 70 to 80 % then that would be a goood result.

Anthony Bray MD :

I would be a bit hesitant to use the most common migraine treatments in you due to your age. The triptans are vasoconstrictors and can increase risk of heart attack. These are meds like Immitrex for example....

Anthony Bray MD :

I would advise that you have your blood checked for inflammatory markers. If you had inflammation of your blood vessels then this can be a cause of headaches. Temporal arteritis is the most classic example of this. The location of your headaches is not typical for this particular disorder but I think it would be of value to have your C-reactive protein and sed rate and ANA levels checked as part of your work up. If you should prove to have a type of vasculitis then it would be very important to have you start medication to reduce the inflammation. A vasculitis also brings on high risk of complications such as stroke. I would also recommend an additional test of an MRA which is an MRI with a special contrast which highlights the blood vessels.

Anthony Bray MD :

Headaches at the top of the head may be caused sometimes by an infection of the sphenoid sinus but this should have been picked up by your head CT if this had been the case.

Anthony Bray MD :

Obstructive sleep apnea can cause headaches and this may be worth considering if you also snore or have excess sleepiness during the day....

Anthony Bray MD :

As you seem to awake with these headaches this also makes me wonder if your neck position may have a role in them. If you had compresssion of the uppermost nerve roots then these do supply the scalp. If your neck was not in a good position at night then it is possible that a headaches might result. You might try using a cervical support pillow and see if this helps at all.

Anthony Bray MD :

Further evaluation of your neck > possibly an MRI of the cervical spine and nerve roots here may be helpful....

Anthony Bray MD :

I hope this information is helpful for you. Let me know if you have further questions and iw ill be happy to get back with you!

Anthony Bray MD :

I do think that the Ultram (tramadol) is a decent medication to try as this is good usually for moderate pain.

Anthony Bray MD :

If my answers have been helpful and to your satisfaction then please remember to leave positive feedback. That would be very much appreciated! Thank you and Best Regards,

Anthony Bray MD :

Anthony Bray MD

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