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Tension headache is commonest cause of headache; so that would be the first diagnostic possibility. But since these were intense and sudden and dizziness accompanied; these need evaluation. Sinusitis is one of the other common cause for headaches. Migraine too is a possibility. I would also like to rule out a brain tumor which though is rare; but need evaluation if this recurs or any neurological issues arise like weakness in limbs or vision disturbances.
Most headaches are caused by following:
Chronic daily headache
Chronic daily headache is not a type of headache but frequent headaches of various kinds. Most people with chronic daily headache have migraine or tension-type headache as the underlying type of headache. Tension headaches are the most common type of primary headache. So probably this would be the first to be considered in the differential diagnosis of her headache also. A tension headache is a headache caused by tense muscles in the face, neck, or scalp. These headaches give a feeling of tightness around the head. The neck muscles can also become sore and tight. Tension headaches can be caused by staying in one position for a long time, such as reading, playing video games or using a computer.
Migraine headaches are the second most common type of primary headache. Cluster headaches are a rare type primary headache.
Nausea and dizziness can occur in migraine headache but it is difficult to differentiate between migraine and tension type headache without an examination. There are other causes of headache also;
1) sinus headache; with your history of nose block surgery, this can be a possibility.
2) Medication overuse headache
3) Post trauma headache; occur after injury or accident.
4) Secondary headache; brain tumor.
Usually a doctor's examination is sufficient to ascertain the cause of headache. But occasionally x-ray of the sinus and CT scan or MRI of the brain may be needed, especially if the headache is persisting for long, or is worsening or is recurrent or is severe and is accompanied by symptoms like vomiting, dizziness, vision disturbances and imbalance. After the tension headaches commonest headaches are migraine.
Please feel free for your follow up questions.
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