Headaches & blurred vision after severe headache.

[atseaMarc]

Hi Doc,
About 7 days ago I developed a really bad headache. I guess you could say it was one of the worst headaches I had ever had. I went to try and sleep it off and when I woke up, I discovered that I now have a problem focusing. The thing is, its not all the time, sometimes I can focus, sometimes I cant. I also now have a constant low grade heachache. 2 days ago I was refered to a emergency room to see if there was a life threatining problem. They perform 2x CT scans. 1 with contrast and 1 without to make sure that I did not have a burst blood vessel or something else. They also wanted to prefom a lumber puncture, but there was not enough time for that so it was just the 2x scans. The 1st scan came back clear. I am still waiting for the results with the contrast. They gave me a CD with the CT images on them, but I guess I would have to take them to a neurologist to interprut. I have also been feeling a bit light headed at times. I have not been sleeping much, even with the aid of drugs, but that might be cos I am so worried. When I close my eyes, I sometimes have a pulsating light in my left eye while the lid is closed. My pupils are also sometimes very large and they seem to be slow when moving from dark into light. Sometimes it almost feels that I have a "film" over my eyes. I am trying to get to a optomologist, but the problem is that I work on a ship and we are at sea for the next 5 days. I am just really panicked that there is something severely wrong. I also have this slight dull pain on the upper right hand side of my head, above my right ear between ear and temple. That might just be tension related bcos I am so worried. I also have a constant headache above both eyes. My eyeballs even feel "sore" Truthfully I am in a flat panic. They had to sedate me in the ER just to talk about the option of a lumber puncture.
Some people have said that I may just be having eye strain and that I need glasses. I am 26yr male with no history of eye problems. I do sit at a PC for long hours in the day. I understand that it is very hard to give any information without a examination, but any advice you could give me would be greatly appreciated.
Thanks in advance.

[John Kenyon, CNA]

One of the questions we ask in emergency medicine when a patient complains of symptoms that include a "bad" headache is "Is it the worst headache you've ever had?" You already answered that question, and that puts something of a red flag on the situation. Now you've walked throught the "worst headache" phase and are still functioning, so the problem, whatever it is, is probably stable -- for now. Please do not wait any longer than absolutely necessary, however, to have this diagnosed, as you have added more symptoms after the initial "herald" headache, all of which suggest something serious may be going on. You're astute to note that it's difficult to diagnose at a distance, but we can at least use broad guidelines to ascertain that something serious may be happening and should be evaluated on an ASAP basis at least.

One thing I'd want if it were me having these symptoms is an actual MRI of the brain rather than CT. Also, that lumbar puncture should have been done and still might be useful (and yes, it sometimes hurts, but it's not horrendous and can be very useful). The visual disturbances are a concern, but moreso the dilation and sluggish response of the pupils. I wouldn't hazard a guess here because there are a number of possible causes, both serious and quite benign, which could be causing this. Just take it under advisement that you'd be fastracked in the ER if I were working there, under neurological emergency algorithms normally in use.

Best of luck to you. Hopefully this is something simple or at least not too complicated. Please follow up with us and keep us updated.