Excessive pressure can build up in the brain from a variety of causes:
- Brain tumors (benign or cancerous)
- Hydrocephalus — excessive cerebrospinal fluid (CSF) which cushions the brain
- Subdural Hematoma — Blood clots (from trauma, that may be only minor)
The headache usually develops gradually, but once it starts, it’s present every day. There may be ongoing nausea, or vomiting. The headache may worsen with straining, or bending forward. New daily headaches that are getting worse, bit by bit, are worrisome.
Diagnosis is easily made by CT scan, occasionally an MRI is useful. We don’t order these tests on everyone with a headache, but we certainly do if the patient has:
- New personality changes
- Abnormal findings on physical exam like slurred speech, partial paralysis, loss of coordination, double vision (not just blurry vision), etc.
- New seizures
- Over 50-years-old with a brand-new type of daily headache
- Daily headache with nausea / vomiting
- Taking anticoagulants (“blood thinners”) (kinds stronger than aspirin)
Treatment, if possible, all depends on what disease is causing the increased pressure.