I had a mild upper respiratory tract infection and later developed a headache in my right side, back, and right ear. Please help.

Q. Are imaging tests or blood work needed for severe headache radiating to the right side, back, and right ear?

Answered by
Dr. Hitesh Kumar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 18, 2023

Hello doctor,

I have had a headache on the right side, back side bilaterally, and above the right ear for the past ten days. It is intermittent. Pain is exacerbated on the right side above the ear while sleeping. But pain is not alleviated by changing positions. It is bad at night, causes sleep disturbances, and the pain is severe. The headache is sharp as opposed to dull. The pain does not radiate anywhere except the areas I mentioned above. I have no nasal discharge or vision problems. I also have no eye pain or tinnitus, and my balance is fine. Tylenol alleviates the pain for four hours, but it then starts again. I do not have a prior history of this ailment and no family history of migraine or chronic headaches. No imaging was done, and my blood work shows mildly elevated cholesterol but no other abnormalities. Just before the headache, I had a mild upper respiratory infection which was treated with Zithromax. Should I be worried about this headache? Is imaging or further blood work needed? Please help.

Thank you.



Welcome to icliniq.com.

I have read your query, and I can understand your concern.

I would like to know some details of your problem:

Since when has your headache started?

Do you have a prior history of similar headaches?

Did you have similar headaches in the past with a gap of a few months?

Where do you feel the headache?

Is it only on the right side and above the right ear?

For how long does one episode last?

How frequent are these headache episodes?

How many times a week do you get headaches?

Do you have vomiting, redness in the eye, watering from the eye, or nasal congestion during a headache?

Do you have mood changes?

Do you have sleep disturbances or problems with vision?

Are there any trigger factors for this headache?

Please follow up with details for the above questions for an accurate diagnosis.

I hope this information will help you.

Thank you.

Investigations to be done:

I suggest you undergo MRI (magnetic resonance imaging) brain with contrast and MR Venogram (magnetic resonance). An ophthalmology examination must be done to check intraocular pressure and for a fundus examination.

Differential diagnosis:

The differential diagnosis for your condition is a cluster headache.

Regarding follow up:

I would suggest you follow-up with the above details for better understanding and further judgment.

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