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Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Medical
Satisfied Customers: 1354
Experience:  MBBS, MD.Currently working in Critical Care Medicine with 6 year experience in internal medicine
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I have been having severe pressure on right side of my Head

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I have been having severe pressure in the right side of my head, its not really a headache, just bad sharp pains, been to a Neurologist and have done a CT & MRI yesterday stated that he did not see anything, I have taken Tylenol, excerdrin, ibroprofen, Loratabs, percocets, the pain does not go away, should i have a lumbar puncture done, headache presuure I so call it.... has been ongoing now for 2 weeks, as this pain is now waking me up at night ....If I press down in this area, pain somewhat goes away... If i move to fast to the right or left or try to lean over to pick something up off the floor, the pain will grab me and I will freeze in my tracks....any suggestions...this pain in the right side of my head is starting to cause me problems with concentration and staying on task at work and home.....Help
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 4 years ago.
Hi,
Im sorry to hear about your problem,

Do you have any vision problems?
Any numbness or weakness in limbs or face?
Any redness or watering from eyes?
Any dizziness?
Is the pain intermittent in nature or continous?
Any other medical conditions? medications?
Customer: replied 4 years ago.

I have noticed some blurred vision off and on....I have numbness in the right arm, as I will wake up in the middle of the night with this happening within the last few months.

No redness of eyes, I do have watering of the eyes (Tearing) periodically in both eyes.

no dizziness..

The pain is both intermittent and continous through out the day..comes and goes (like a dull ache pressure in the head)

Neurologist prescribed Loritab for pain and Anti depressant for me to take at night

(as I am not depressed though) I find that this medicine is not helping, been taking it for over a week now...

 

Expert:  Dr. Muneeb Ali replied 4 years ago.
Thanks for the additional information,

Well there are a number of conditions which can explain your symptoms and these wouldnt show up on a normal MRI or a CT scan of the brain as well. Now the first thing to be considered in your age group and particularly in females is that of Migraine. This pain that you have could be due to a Complicated Migraine which is a sub type of Migraine in which numbness and even paralysis on one side of the body can occur. Now Migraine is a clinical diagnosis as no test can definitively diagnose this condition. This condition once diagnosed by exclusion of other more dangerous diseases such as an aneurysm or tumors or even strokes, can be treated with several drugs which can prevent an attack as well. A good strategy is to use drugs like zolmitriptan or imitrex or sumitriptan to abort an acute attack of the migraine and if the pain responds to this drug then it more or less diagnoses the condition. Afterwards several types of drugs can be used to prevent further attacks from occuring suich as,

Flunerazine
Beta blockers
Topiramate
Valproic acid

Among many other options.

Another possiblity which should be considered in your case is that of vertebral artery dissection which would manifest as changes in vision alongwith weakness or numbness of one side of the face alongwith dizziness and hearing disturbeances as well. This can be picked up by getting a CT angiogram done of the vessels in the neck and once this is diagnosed the treatment is basically surgical.

Lastly i would also advise getting yourself checked for temporal arteritis which is a condition in which blurring of vision alongwith the type of headache which you have described is common. This can be diagnosed by running a simple tests known as ESR which would be raised in this condition. Definitive diagnosis can be made by doing a biopsy of the temporal artery which runs alongside the head. This can then be treated with simple painkillers alongwith steroids in the dose of prednisone 60 mg per day for a short period of time.

i would suggest that you contact your neurologist and discuss these options with him because youre already on strong painkillers which dont seem to be working and getting to the root of your problem is the key so that you can control these headaches and get better. I hope this helps

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Dr. Muneeb Ali, Doctor
Category: Medical
Satisfied Customers: 1354
Experience: MBBS, MD.Currently working in Critical Care Medicine with 6 year experience in internal medicine
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