Hi,

On Christmas Day I was suddenly hit with a head pain that my husband had to help me to a chair ..I was holding my head i could not scream the pain was bad!!! But then my left arm had a shooting pain that made me unable to use my hand was like paralized.My husband called the EMS i spent 2 days there.

my CT nothing,MRI nothing ,spinal tap clear…So i was sent home after two days of shots around the clock for pain .No appts no meds and I thought it was all over ,but it hit me very hard worse than the 1st time 2 days later so my husband called the neurologist that took care of me in the hospital and he put me on Topamax it just got worse and he just increased the topamax ..100mgs twice a day .

I am 40 days with this head clamp on the back of my head,my forehead feels like my brain is swelling,the top of my head is a hammer pain,!!!!!Vain in my neck hurts ,sharp pain up my arm and my hand goes paralized.(Left side)…and he continues to tell us it takes time ,but I can not take anything to relieve the pain except sleep and that is 4-5 hrs. Can you help me ?

I went to the emergency room again last nite and they did a Cat scan it was normal.

They gave me a pain shot which did nothing for my head,but I was Thankful for them trying !

They also got a copy of my MRI that I had on Christmas…The Chief Doctor of the emergency room came in and checked me looking at my left arm that was very weak and sharp pains shooting up …Well my main concern was that he told me I need a Brain Biopsie and with in a sec. He was called out of the room and I never seen him again and was released???

My husband and I are very worried we seem to get no answers and my pain gets worse !!!!

I do have a APPT. with a new Neurologist tomorrow for a second opionion.

Doctor Joshua’s Answer:

Hi, thanks for the question. I’m happy that you were thoroughly examined when the headaches first started. The usual serious causes such as subarachnoid hemorrhage (aneurysm rupture) were excluded.

Your best bet is indeed to see a neurologist specializing in headaches. The comment about brain biopsy is a bit puzzling, but of course without examining you physically or even seeing the MRI it’s very hard for me make a comment about that.

Please understand that without knowing your history thoroughly and without examining you physically and seeing your MRI/CT pictures, I cannot offer diagnosis suggestions for you, but I’ll mention some general points that you may discuss with your neurologist.

One possible scenario in a case such as yours is that what was originally a migraine or some other benign headache has turned into a complication of the spinal tap. Sometimes, post-lumbar puncture (spinal tap) headache, can lead to prolonged headaches, sometimes lasting even months. This is due to what is called intracranial hypotension and is caused by a continuous leak of cerebro-spinal fluid through at the puncture site. This is often treated successfully with an epidural blood patch. The notable feature of such a headache is that it is worse when standing up, and gets better when lying down.

Other than that, diagnosis of prolonged headaches requires a thorough history, equally thorough physical and neuro exam and ophthalmoscopy, these are especially important when radiology has been done and found normal. Re-evaluation of the radiological images may in some cases be necessary, because there are some findings that may sometimes go unnoticed at first, such as pseudotumor cerebri, or idiopathic intracranial hypertension (notably in overweight women). Of course, there are numerous other possible causes for headaches, including such benign causes as migraine and tension neck headache and it’s definitely a good idea to see a neurologist about this.

Good luck, and keep us posted!

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