HomeAnswersNeurologyheadacheAm I receiving the right treatment for my headache?

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

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Ashok Kumar

Medically reviewed by

iCliniq medical review team

Published At October 10, 2016
Reviewed AtAugust 1, 2023

Patient's Query

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 had enlarged blood vessels in my brain, and my neurologist has said they are tortuous vessels. I suffered a brain injury eight months before. 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 let it drain on its own. However, for the last one month, I have had a headache. It is on the same spot where I had an injury. Last week, my wife took me to the hospital, and I was given a shot without a CT scan or any other testing. After a shot, I was sent home. I always feel sick, and I vomit when I have a headache. I used to take Tylenol or Advil 600 for headaches. This is ruining my life. Please help.

Answered by Dr. Ashok Kumar

Hi,

Welcome to icliniq.com. I have read your query, and I understand your concern. Regarding the first brain injury incident, I understand that collection of blood was there following the skull fracture. I guess it was an extradural hemorrhage. It is not always necessary to perform surgery in such cases as sometimes 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 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 a CT (computed tomography) scan or MRI (magnetic resonance imaging) is not necessary for a patient with migraine, pain localized to the injured area in the past warrants proper evaluation by 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 the following details for your migraine so I can assist you in its management. 1. For how long are you suffering from this problem? How was it 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. 2. Is there any history of similar complaints in the family? Do you have any other medical illnesses? 3. Also, let me know the medications tried to date and their response. After evaluating the information on all aspects of your illness, I will revert to you with possible suggestions and guidance.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ashok Kumar
Dr. Ashok Kumar

Geriatrics

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