頭痛劇烈怎麼辦？

Q: I often...HeadacheI experience headaches about twice a month on average, and each time I vomit violently. This has been going on for six years, but the frequency has increased since last year, and it's no longer as regular as before. I never take painkillers; I just let the pain run its course. When the pain reaches a certain point, I start vomiting, and after vomiting, I fall into a deep sleep, and I feel better the next day. Last month, my blood pressure suddenly spiked to 160. I went to the doctor and had an EEG done, but nothing was found. What department should I see, or what further tests should I have? What should I do about these headaches?
A: Dr. Wang Pei-ning, Attending Physician of Neurology, Taipei Veterans General Hospital

Headaches come in many forms and can be broadly categorized into primary headaches and secondary headaches based on their cause. When people experience headaches, their biggest concern is whether they have a brain tumor or a stroke. Headaches caused by tumors, strokes, or central nervous system infections are secondary headaches. However, most headaches, especially chronic headaches, are primary headaches, with migraines and tension headaches being the most common.

Based on your described symptoms—"headache and vomiting, followed by drowsiness, and feeling better the next day"—migraine is the most likely diagnosis. Migraine is a very severe headache, and most attacks occur on one side, but about one-third of people experience attacks on both sides. Many people also experience unilateral headaches at the onset, which gradually spread to both sides or the entire head.

The headache feels like a throbbing pain. Migraine attacks are often accompanied by nausea, vomiting, photophobia, and phonophobia. The pain can last for more than 4 hours, but it usually subsides within 2 to 3 days. Vomiting may occur at the peak of the pain, but the symptoms usually gradually improve after vomiting.

womenTilting headMigraines are often related to hormonal changes, so some people are most prone to pain around their menstrual period. Migraines often improve in the mid-to-late stages of pregnancy, but become more severe after childbirth.

Since your headaches have become more frequent and irregular, it is recommended that you see a neurologist for examination and treatment. Regarding your blood pressure, please measure it at the same time every day, including both when you have a headache and when you don't. Record the data for a while, and then show it to your doctor during your consultation to determine if further examination or treatment is needed.