Q. Can a migraine and a tension-type headache coexist?

Answered by
Dr. Devavrat Harihar Nene
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 13, 2017

Hello doctor,

In short, I have a baby who is now 9 months old. I have started having a visual aura (fortification spectrum) and migraine around two months ago. The aura was almost always on the left side of the vision and the headache (which was quite mild), was on the right side of my head, at the back of my head (occipital area). One day after the migraine, I could feel pain at the back of my head on the right, whenever I leaned forward or shook my head, and then it would go away. I have had around seven episodes so far.

Often, between migraine episodes, I also had tension-type headaches which might have been from stress, I do not know. It felt like a bad ache around my head and occasionally, sharp pains in various areas. There was no pain with movement or exertion. I had an MRI (+MRA) one month ago, which found nothing of concern. However, it was done without contrast as they said that the technician decides if the contrast is needed.

In the last few days, I have started having this pain at the back of my head, on the left side (not on the right like I have with the migraine), whenever I bend over or strain when bending over. It is around the occipital area and a bit lower as well. I can also feel it when I shake my head. It is a sharp pain. It started after I went to an aerobics class. I have just started working out again. I am not sure if it is related. It has not gone away though, and I can sometimes feel discomfort and slight pain with various movements as well.

I am really stressed out about this. I keep having these headaches and these symptoms (aura) which I have never had in my life, and I am worried and feel overwhelmed and cannot take proper care of my baby. I am always checking myself and shaking my head. I am worried that they might have missed a tumor with the MRI because it did not have contrast. I read that this kind of localized pain on movement and straining can indicate a tumor. What do you think I have? Can it be related to something other than a tumor? What should I do?

#

Hello,

Welcome to icliniq.com.

  • This looks like it is related to a subconscious anxiety and stress. It does not look like a migraine. However, the aura and the previous headache are classical of a migraine.
  • As your baby is 9 months old, you must be breastfeeding her. So, we will avoid any migraine prophylaxis at present.
  • And to answer your question, I am very much certain that an MRI does not miss a tumor even if a contrast is not given. So, there is absolutely no need to worry.
  • It is this worry that is the root cause of your problems. So, let us deal with it one by one. I suggest the following:
  1. Proper and regular sleep.
  2. Healthy diet.
  3. Regular exercise in moderation.
  4. Tablet Paracetamol 500 mg SOS for severe headaches.
  5. Mindfulness meditation.

All this will work wonders. Take care.

For more information consult a neurologist online --> https://icliniq.com./ask-a-doctor-online/neurologist


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