Q. May I know if I am receiving the right treatment for my headache?

Answered by
Dr. Ashok Kumar Choudhary
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Oct 10, 2016 and last reviewed on: Sep 17, 2020

Hi doctor,

I am a male of 31 years. I have suffered from migraines or headaches ever since I was a child. Recently, I was told that I have enlarged blood vessels in my brain and my neurologist has said they are tortuous vessels. I suffered a brain injury before eight months. I collapsed at home and I suffered a bleed on the outside of the brain and a skull fracture. I was hospitalized for five days. They did not need to evacuate the blood and they let it drain on its own. However, now, for the last one month I have a headache. It is on the same spot where I had an injury. My wife took me to the hospital last week and I was given a shot without a CT scan or any other testing. After a shot, I was sent home. I feel sick always and I vomit when I have a headache. I used to take Tylenol or Advil 600 for headache. This is ruining my life. Please help.

#

Hi,

Welcome to icliniq.com.

I read your query and understand your concerns.

  • Regarding the first incident of brain injury, I understand that collection of blood was there following the skull fracture. I guess it was extradural hemorrhage.
  • It it is not always necessary to perform surgery in such cases as sometime the risk of surgery is more than the collection of blood.
  • On other occasions, (probably this was the case for you) the amount of blood collected between the scalp layers was too low and there was no possibility of complication was suspected.
  • In my view, they have done the right things as there was no complication across the last six months and you did not suffer any bad event during this period. I assume this was the case, if not so you can clarify.
  • Although, CT scan or MRI is not necessary for a patient with migraine, but pain localized to the injured area in the past warrants proper evaluation by use of blood work and brain imaging using either CT scan or MRI brain.
  • In my view they need to look beyond the migraine when you have tortuous vessels and chronic migraine.
  • Having said this I request you to post following details for your migraine so I can assist you in its management.
  • How long there is a problem? How it was started? Whether it was acute or slowly increased over time?
  • Please let me know the frequency of headache, days lost due to headache in a typical month, nature of headache, factors relieving or aggravating headache, duration of headache for a typical episode and associated symptoms.
  • Is there any history of similar complaints in the family? Do you have any other medical illness?
  • Also, let me know the details of medications tried till date and their response. After evaluating the information on all aspects of your illness, I will revert back to you with possible suggestions and guidance.

Revert back with the details requested to a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist


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