Dear Ask The Doctor: Dear Doctor, I'm 47, healthy female. Except having constant sharp headache for about 6 months, the headache alwayse centralize in certain area, behind right eye. The headache always comes with flu-like symptom: weak, nauseous, sleepy. I had magrin and can be recoverred by Telenol. For this type of headache, it is different feeling of previouse megrin, I have to take a nap to recover. Definately, less sleep time (less than 6 hour a day)worses the symptom, exercise makes me better. The symptom alwayse start in the morning, if I wake up with the headache, I may suffer whole day or I may recover after move around. About year ago, my blood pressure goes up, 140-80 form 90-60. Once I have severe headache, my blood pressure reached 190-100 (I took the blood pressure medicin the first time, the blood pressure dropped to 160-90 after one hour), rest can make all symptoms better or disappearred. I also noticed one day, I totally forget my office-mate's name, just like my brain is washed, but at the same time, I still can handle complicated scientific analysis. Question: 1. Does it look like some physical change in my brain? 2. High blood pressure is cause or result of headache? 3. Early sign for Alzheimer? 4. What type of doctor I should see?
Dear Tao: It is really difficult to say what is the cause of your headache. Headaches can be of 2 types :
Primary headache like migraine, tension-type headache and cluster headache may not have an identifiable cause.
Secondary headaches are caused due to involvement of surrounding tissues and structures for example pain in the cervical spine may present as a headache.
There are some important factors that you've mentioned that warrants a visit to a doctor
i) Your age, 50 years or more.
ii) Your headache has changed in character
iii) You've had mental confusion
iv) You have morning headache
Sometimes these symptoms may indicate that there are other factors causing your headache like increased pressure in the brain due to infection or tumor, stroke or bleed into the brain. Yes, high blood pressure can definitely be a cause of your headache. You will need to visit a Neurologist to rule out secondary causes of headache. It is helpful if you keep a headache diary in which you note the time of the headache, how long it lasted, severity, any contibuting factors and how was it relieved.