Bizarre headache

August 29, 2009 5:28 PM

Focal headache. How much should I be concerned?

After my folks and I went to dinner, I noticed on the drive back that there was an area of pain about 2 inches in diameter above my right temporal lobe just to the side of the central fissure. It was very mild pain which lasted for about 15 minutes. I observed no other neurological abnormalities - no slurred speech, no vision problems, nothing.

My neurological knowledge indicates that this 1) is not a typical headache because it is unilateral and focal and not on the entirety of my head and 2) because it is focal, may or may not be indicative of either a meningeal issue or a cerebral issue.

I'm not sure whether I should be worried about this. My first impulse is that, because the pain was relatively mild, I shouldn't be, but the headache was abnormal.

posted by kldickson to health & fitness (16 answers total)

Erk. Not temporal. Parietal.
posted by kldickson at 5:29 PM on August 29, 2009

Is this the only episode?
posted by grobstein at 5:31 PM on August 29, 2009

Yes.
posted by kldickson at 5:31 PM on August 29, 2009

I get all kinds of headaches infrequently. Not as bad as I used to, but I've had them like this. I will be 40 in a year. I wouldn't worry unless it persists.

And I've even had aseptic meningitis, so I know what that feels like too.

Someone will tell you to see a doctor, but honestly, there is a reason there are so many OTC painkillers out there.
posted by cjorgensen at 5:35 PM on August 29, 2009

Anecdotal evidence only, but I used to get migraines/cluster headaches/what have you all the time in college where it would feel like someone was driving an ice pick in just one spot right behind my left eye. Other than wiping me out for most of a day at each occurrence, there were no lingering effects, and I don't get them any more.
posted by MsMolly at 5:37 PM on August 29, 2009

Typical? I guess not. But a whole hell of a lot of headaches stubbornly resist conforming.

Focal doesn't mean much. Not meningeal or cerebral. Cerebral problems don't cause pain unless they irritate pain-sensitive structures like meninges or blood vessels. The cerebrum's got no pain nerve endings of its own. And those aforementioned pain-sensitive structures are largely innervated by visceral-type nerves and give a broader ache rather than a pin-point focal pain. Maybe it was somethingin the skin, in a follicle, something like that.

If it's gone and it don't come back, okay. Maybe it's just clavus hystericus.
posted by adoarns at 5:53 PM on August 29, 2009

What to keep an eye on:
- intensity of pain, and whether it increases over time
- whether pain continues, growing more constant, or comes and goes
- whether light and/or moving lights seem to affect the pain
- whether dizziness is a symptom, and if that dizziness grows, and you have problems walking
- if you've had past head injuries or a concussion, pay particular attention to your symptoms over next day (this last one is the important one)

That's all I can remember off hand - I have zero medical background but I had a bleed in my brain (technically cryptic arteriovenous malformation if we want to get all latinate) back in 2004 and with something like that the pain starts out like migraine from hell (that bam, came up without warning) and gets worse. Excitingly worse - vision, mobility just go. You'll definitely not be in question that Something Is Wrong. So the good news is that until you get hellish scary pain - probably not bleeding up in there, unless you have a high pain tolerance. That's your worse case senario. Doesn't sound like you're anywhere near that - so take a deep breath and relax, that's one fear you can put away for now. (Unless you have a concussion in your past. Then start taking notes and notice if any symptoms change for you. Not saying this to be scary - just like to keep past head injury folk aware of this sort of info.)

Migraines however are tricky things, can have different kinds and intensities of pain - and annoyingly multiple causes. Sometimes those headaches can be weird and in one area - but it's only a problem if the pain keeps up and/or gets worse. Usually they go away. Watch the intensity of pain and whether it continues. If you're forgetful (like me) make note of symptoms, the time, and what you ate - in case this is caused by a reaction to food somehow. Your doctor will go over foods you've eaten to try and try to rule out food allergies - so its easier to have this written down.

Until your symptoms get obviously worse I'd just keep an eye on things, and see if staying away from bright light, lying down, not reading or watching tv, etc. helps. Definitely see your doc on Monday if you have continuing problems - at least talk to the nurses over the phone (if you have nurses like that to talk to, they're getting rare) and see what they suggest.

Again - I've got no medical training, this is only from past experience, and what to keep an eye on. Taking notes gives you something to refer to should you see a doc later ("so when did this pain start?") - if you feel better just toss em and go on with life. And I hope you feel better. All headaches are awful.
posted by batgrlHG at 6:07 PM on August 29, 2009

I'm no neurobiologist or anything so don't have to trust me on this, but I've had this happen a couple times, in both the temporal and parietal lobes, and my doctor said that these were probably just atypical cluster headaches. No need to worry.
posted by thisjax at 6:16 PM on August 29, 2009

I know the pain isn't coming from the brain because the brain has no pain sensors - that's why they do awake brain surgeries. At the same time, headaches can occasionally be indicators of something wrong with the brain underneath.

As I said, the pain only lasted for 15 minutes. I'm monitoring that part of my head to see if the pain comes back.
posted by kldickson at 6:21 PM on August 29, 2009

Huh, my headaches are often in just one little area -- a throbbing in one temple, or behind an eye. I thought this was normal. In any event, as others have said, I wouldn't worry about a short-lived, mild headache.
posted by palliser at 8:04 PM on August 29, 2009

IANAD. FWIW, I've had such headaches since I was a teenager. I'm in my early 40's now. Frequency: average of 10-14 days a month. More irritating than intense. 90% of the time, 800 mg of ibuprofen takes care of it. So far, apart from the headache itself, no adverse effects that I am aware of. As long as your headaches are mild (mine are), and you have no other symptoms, my one rat anecdata says you have little to worry about for however long my age minus your age is.
posted by VikingSword at 9:35 PM on August 29, 2009

They perform brain surgery while keeping the patient awake because certain areas of the brain need to be monitored (such as those that control speech and perception of reality) in real time, so they know if something they are doing is negatively impacting one of said areas. It has nothing to do with pain.

That being said, I had a large cyst removed from my brain 3 months ago and that followed almost a year of unrelenting and intense pain. I also suffer from migraines on a frequent basis which are very focal but quite intense.

Not to be snarky, but I'd give anything to feel so compelled by a mild, short-lived headache that I needed to ask metafilter about it.
posted by sickinthehead at 7:52 AM on August 30, 2009 [1 favorite]

Keep a log of when the headaches come on and how long they last and make an appointment with a neurologist, ideally one who specializes in headaches. It can take months for a new patient to get in to see a specialist. Might as well have the appointment scheduled and cancel if you don't need it.

In the meantime, see an eye doctor. There's a chance that your eyesight is worsening and you "just" need a new prescription or glasses if you don't already have them.

I'm not a doctor. I have chronic pain on one side of my body that began years ago as a headache behind my eye. I'm not suggesting you have anything serious, I am suggesting what I would do in hindsight (ha! another one) if I could start all over again.
posted by vincele at 9:41 AM on August 30, 2009

How serious can a one-time mild headache that lasts for only fifteen minutes be? Those are extremely common and don't generally mean anything at all. Get concerned only if it hurts a whole lot and/or does not go away quickly.
posted by Ery at 11:04 AM on August 30, 2009

Do you wear glasses/contacts? Did you have any caffeine? I get stabbing pain on one side of my head for a few minutes at times...usually when my prescription is too old, my eyes are tired, or I've had too much caffeine. If I'm stressed these headaches increase. My usual headache is always focused on one side. Going to the optometrist and sleeping more/avoiding caffeine help me.

2nd vincele. Never hurts to see a doctor if you're worried.
posted by shinyshiny at 4:09 PM on August 30, 2009

Did you by any chance have any wine when you were at dinner? I'm not suggesting drunkenness - even half a glass of some [but not all] red wines give me a terrible headache.
posted by st looney up the cream bun and jam at 7:24 AM on September 7, 2009