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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 8999
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I have occasional sharp pain at the top of my head, back of

Customer Question

I have occasional sharp pain at the top of my head, back of head, or side of head. Sometimes months will go by, and I will not have these pains at all. On other occasions they recur with some frequency during the course of a day. I have had severe gingivitis, and I have the sense of a correlation between the most severe gingivitis and frequent episodes of these pains. About 2 months ago I was prescribed a very strong antibiotic by my dentist and had a "deep cleaning" by the dental hygienist, and all of the gum inflammation disappeared.
I have had an MRI, and have been seen by a neurologist at the stroke clinic in one of our hospitals. I was advised that there is nothing in the MRI that is abnormal for someone my age -- early seventh decade.
However, I have had recurrence of these pains today, strong sharp sensations at the top of head, and sense of weakness in my legs as I walked up a mild incline to our home, about a quarter of a mile. When I came home, my hands were shaking as well. Thought there might be a sugar issue (not diagnosed with diabetes or hypoglycemia, although fairly frequent blood tests) so I ate some yougourt, a pear, some arugula, and felt a bit better, but had to rest for about an hour before I felt myself again.

What can be causing these pains in my head? Are they precursors to an aneurysm or other form of bleeding in/around the brain? Are there some foods which might cause dilation or other change to blood vessels in head/brain?

Will be appreciative for any thoughts or ideas.
Submitted: 4 years ago.
Category: Neurology
Expert:  Dr. Frank replied 4 years ago.

neuromd2012 :

HI


 

neuromd2012 :

What you are describing is called "ice pick" headaches as described by the international classification of headache.

neuromd2012 :

They are described as being sharp pain, very brief, and in the occipital, sides and top of the head, sometimes the forehead as well


 

neuromd2012 :

They are said to be rare, but some studies suggest that up to 3% of headache patients have this type of headache.


 

neuromd2012 :

I should say up to 3% of migraine headache patients have headache like this


 

neuromd2012 :

they are said to be associated with a history of migraine, do you have a history of throbbing unilateral headaches with nausea/vomiting, and light bothering your eyes?


 

neuromd2012 :

I will find a webpage on this type of headache and paste it in, please review this and get back to me with questions ok?


 

neuromd2012 :

here it is as a description in the international classification of headache, I guess they changed the name to primary stabbing Headache.


 

neuromd2012 :

Drugs used to treat this type of headache are again based on if there is a history of migraine. If there is, a medication like sumitryptam or imitrex is usually tried first. If there is no history of migraine, then indocin or indomethacin 25 to 75 mg up to 3 times a day (a special NSAID) or elavil (amitryptaline) 25 up to 200 mg a day, an SSRI which is used in chronic daily headache is tried


 

neuromd2012 :

get back to me if you want to discuss this problem. Or if you are satisfied with this answer,please hit the accept button as that is how I am compensated for this work thank you XXXXX


 

Dr. Frank and 3 other Neurology Specialists are ready to help you
Customer: replied 4 years ago.
I just spent 20 minutes preparing further information, but somehow it was wiped out due to a processing error! I am prepared to accept your answer, but if I have more information to provide that might alter your recommendation, can I go further with this inquiry? In any case, I will accept your answer, as you should be paid for what you have already done. Thank you for your response.
Expert:  Dr. Frank replied 4 years ago.
HI. come back. Listen, this isn't all about money. I want to discuss this with you more until you are satisfied. can you type in the information again, I am doing that all the time as the software is terrible sometimes.. I really thought you had ice pick headaches based on what you told me. get back to me
Customer: replied 4 years ago.
Now that I have read about them, I think that I have had ice pick headaches. I am surprised though that they are so-called primary headaches, i.e. that they are sui generis, and not a function of some other underlying problem. I think I will send this bit now, and forward more text in short chunks lest I once again see my efforts erased by the software!
Customer: replied 4 years ago.

Now that I have read about them, I think that I have had ice pick headaches. I am surprised though that they are so-called primary headaches, i.e. that they are sui generis, and not a function of some other underlying problem. I think I will send this bit now, and forward more text in short chunks lest I once again see my efforts erased by the software!

I don't think I could take indomethecin because of its impact upon the GI system. I have Barrett's esophagus, and could not manage medication which will exacerbate reflux etc. I have also had suspected detaching retina, and have had to have laser surgery to repair a retnal tear. I was sent to stroke clinic after emergency admission, when I woke up one morning and for about a minute or so could not experience normal vision in one eye. Couldn't see the external world from the one eye, just a reddish image of the small blood vessels of the eye itself. But vision came back after the minute.

I am also about to be examined for possibility of polycythemis vera. The Barrett's, the acute gingivitis, extreme itching after shower, and other things suggest I might have it. It appears my mother may have had pv. It seems that my ankles, feet, and wrists are also now damaged by some kind of inflammatory arthritic process, and this too is being investigated.

Customer: replied 4 years ago.

Now that I have read about them, I think that I have had ice pick headaches. I am surprised though that they are so-called primary headaches, i.e. that they are sui generis, and not a function of some other underlying problem. I think I will send this bit now, and forward more text in short chunks lest I once again see my efforts erased by the software!

I don't think I could take indomethecin because of its impact upon the GI system. I have Barrett's esophagus, and could not manage medication which will exacerbate reflux etc. I have also had suspected detaching retina, and have had to have laser surgery to repair a retnal tear. I was sent to stroke clinic after emergency admission, when I woke up one morning and for about a minute or so could not experience normal vision in one eye. Couldn't see the external world from the one eye, just a reddish image of the small blood vessels of the eye itself. But vision came back after the minute.

I am also about to be examined for possibility of polycythemis vera. The Barrett's, the acute gingivitis, extreme itching after shower, and other things suggest I might have it. It appears my mother may have had pv. It seems that my ankles, feet, and wrists are also now damaged by some kind of inflammatory arthritic process, and this too is being investigated.

I should have added that I do NOT take any proton pump inhibitor medication. Talk about headaches!! It took my two weeks to get over the headache I experienced from the Nexium. So, after half a year on it, I gave it up. And although I have to deal with the Barrett's symptoms, this is preferable to the incapacitation occasioned by the Nexium.

Customer: replied 4 years ago.

Now that I have read about them, I think that I have had ice pick headaches. I am surprised though that they are so-called primary headaches, i.e. that they are sui generis, and not a function of some other underlying problem. I think I will send this bit now, and forward more text in short chunks lest I once again see my efforts erased by the software!

I don't think I could take indomethecin because of its impact upon the GI system. I have Barrett's esophagus, and could not manage medication which will exacerbate reflux etc. I have also had suspected detaching retina, and have had to have laser surgery to repair a retnal tear. I was sent to stroke clinic after emergency admission, when I woke up one morning and for about a minute or so could not experience normal vision in one eye. Couldn't see the external world from the one eye, just a reddish image of the small blood vessels of the eye itself. But vision came back after the minute.

I am also about to be examined for possibility of polycythemis vera. The Barrett's, the acute gingivitis, extreme itching after shower, and other things suggest I might have it. It appears my mother may have had pv. It seems that my ankles, feet, and wrists are also now damaged by some kind of inflammatory arthritic process, and this too is being investigated.

I should have added that I do NOT take any proton pump inhibitor medication. Talk about headaches!! It took my two weeks to get over the headache I experienced from the Nexium. So, after half a year on it, I gave it up. And although I have to deal with the Barrett's symptoms, this is preferable to the incapacitation occasioned by the Nexium.

I am a professional, and while these symptoms affect my work to a certain degree, they are preferable to the side effects of the medications.

I commenced this inquiry because I wondered whether the headaches were somehow related to the inflammatory processes which seem to be at play with the other problems/symptoms!

I would really like to add something to your remuneration, but cannot get back to the screen which allows me to do that.

Expert:  Dr. Frank replied 4 years ago.

HI yes, I don't think you could stomach indocin, literally. I have to think about what would work for this. you could try a 50 mg tab of imitrex? and see if it helps. get back to me if you want to discuss and thank you .Dr Frank T.