Headaches and negative mri

roseanne

I have been having nauseating headaches for 5 weeks. Have been in the er 3 times. MRI is negative for brain mets. At my wits end as the headache and sometimes neck pain are debilitating. Primary Dr. is mildy concerned. Not sure what to think. any thoughts, experiences? Thank you in advance.

Roseanne

RebzAmy

Hi Roseanne, a while back I did some research into this sort of thing and please see below, which might help you.

Definition

A cervicogenic headache is, by its definition, any headache which is caused by the neck. The term 'cervicogenic' simply refers the cervical area, which is a part of your spine located right near the base of the skull. The pain of cervicogenic headache is usually unilateral; it originates in the neck and then spreads to the oculofrontal-temporal areas of the head. The headache initially presents as intermittent episodes and then progresses to an almost continuous pain. Pain may be triggered or exacerbated by neck movement or a particular neck position; it can also be triggered by applying pressure over the ipsilateral upper part of the back of the neck or the ipsilateral occipital region.

Causes

One of the most prominent causes of a cervicogenic headache is simply undergoing an excessive amount of stress to your neck and spine.

Risk Factors

There are several factors that can contribute to making cervicogenic headaches more severe or happen more frequently. These include fatigue, problems sleeping, disc problems, current or prior injuries, poor posture and stress on the muscles.

Symptoms

Common symptoms of a cervicogenic headache include a steady, non-throbbing pain at the back and base of the skull, sometimes extending down to the neck and between the shoulder blades. The pain can also be located behind the brows and forehead. Because of the location, most of the pain is felt in the head, even though the problem is originating from the spine. Pain usually starts after a sudden neck movement, such as a sneeze. Along with head and/or neck pain, symptoms may include nausea, vomiting, dizziness, blurred vision, becoming very sensitive to light or sounds and feeling pain down one or both arms. The neck also becomes very stiff and the patient may have trouble moving.

Diagnosis

The workup of cervicogenic headache begins with a careful history taking and physical examination and order of appropriate diagnostic studies that includes standard radiographs, 3-dimensional CT, MRI, and possibly electromyography; nerve blocks may also be used to confirm the diagnosis.

Treatment

Pharmacologic management of cervicogenic headache usually starts with simple analgesics, such as NSAIDs, aspirin, and acetaminophen; the response varies from patient to patient. Combination products (eg, hydrocodone/acetaminophen and butalbital/acetaminophen/caffeine) often are prescribed but cannot be recommended, given the potential for residual and rebound effects. If all other treatment fails, judicious use of an opioid can be tried, using a sustained-release medication on an around-the-clock basis for persistent headaches to avoid a rebound effect. Invasive procedures include trigger point injections, greater or lesser occipital nerve blocks, facet joint blocks, segmental nerve root blocks, and diskography; spinal manipulation; and behavioral approaches.

Prevention

There is no direct and identified prevention measures that could certainly help a person avoid episodes of cervicogenic headaches. However, as always, you are advised to take healthy diets, get proper sleep and reduce overall tension.

roseanne

Thank you for this information. I really appreciate it. The primary is calling for a bone scan which considering my history seems prudent. Thanks again.

RebzAmy

Good luck, I'll be thinking of you

Hugs

sbelizabeth

Roseanne, "nausea" and "headache" sound like migraine.

bride

Indeed, as Sbelizabeth said, it may be migraines. There's an uncommon type of migraine called cerebellar migraines which cause pain where you describe it. Fortunately, they're treatable with BP meds. Remember I'm not a medical anything so my thoughts carry no weight.

I hope you keep pushing till you get an answer and that the answer is good.

bride

Kicks

Apprpx. a yr after TX I developed a horrendous pain behind and around my right eye (I normally never have even mild 'headache). No pain (even 'heavyduty') meds would do anything on it. That weekend I was going to a Retreat that I knew my PA would be at so I could talk to her. She had me in to eye clinic Mon morn followed by an MRI. No problem showed up at all. The thought was that a nerve was 'irrigated/aggravated for some unknown reason so went on Dexamethazone. Pain went away rapidly and at the end of 2 weeks when I went off it, it never came back - that was 4+ yrs ago and still no issues so for whatever reason - it worked. Sometimes 'thinking' out of the box' works and is what is needed.