Last night I had the worst headache of my life,

Patient : Last night I had the worst headache of my life, it hurt to talk, it hurt to think, I almost went to the er, it hurt so much. But then it started to subside, and I got nauseous; when I threw up, I felt better. I've had migraines, this wasn't one, I'm wondering if I should go see my gp, or if its gone, then I'm better. ...
Doctor :   Welcome to Ask The Doctor. We understand your concern. Based on the details provided by you following are the poss ibilities in your case: 1.Crash migraine- Severe headache of sudden onset, that can occur in people already suffering from Migraine. Migraine headaches may have an abrupt onset. Cluster headache also may be sudden and excruciating, but it lasts only 15-180 minutes but usually patient has no prior history of headache. 2.Exertional headache- precipitated by strenuous activity and build in intensity over minutes. 3.Intracranial aneurysm- A ruptured intracranial aneurysm is the primary consideration if the headache is severe and of sudden onset and reaches maximum intensity in minutes. The classic presentation of an aneurysmal subarachnoid hemorrhage (SAH). So, you need to be evaluated by a CT Scan for this purpose. If there is no evidence of any SAH, then you will be treated for migraine headache. Migraine headaches are treated with drugs like Flunarizine, Propanolol, Amitriptyline. Share my opinion with your doctor. I hope it helps. Stay Healthy.

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