BODY SIGNAL: HEADACHE IN THE MORNING, MADE WORSE BY SNEEZING, COUGHING
Description and Possible Medical Problems
Some people get their headaches most often in the late afternoon or evening, after the stress of the day finally hits them.
Other people, however, are prone to headaches in the morning, and though the pain might be just barely there, the headache is often brought on by a cough or sneeze. Though brain tumors rarely occur, your doctor will probably want to check for evidence of one, especially if you have a history of either breast or lung cancer. A headache that appears in the morning will raise the possibility that the cancer has spread to the brain.
If you regularly have headaches in the morning that start when you cough or sneeze, see your doctor, especially if you’ve fought cancer in the past. Your doctor will first perform a complete neurological evaluation to determine if you have a brain tumor. This will include taking your complete medical history, doing a physical exam, and performing routine lab tests, including an electrocardiogram and an electroenceph-elogram to check for any seizure activity. A neurological exam will include a pinprick test, a hammer reflex test in which the doctor hits just below your knee with a rubber hammer, and a check of your visual fields as well as your muscular strength. He will also probably perform a CAT scan of your brain or an MRI, which will show any signs of a tumor, hemorrhaging, or an enlarged blood vessel, which is a sign of an aneurysm.
If your doctor strongly suspects that you have a tumor or an infection of the brain, he may want to perform a spinal tap or a lumbar puncture, which will help confirm or rule out either of these diseases. First he will give you a local anesthetic. Then a small needle is placed at the base of the spine in order to withdraw a small amount of fluid so that it can be analyzed by a lab for signs of an infection or tumor. After the test, you will be advised to stay in bed for at least 12 hours, and you might have a headache for a day or two following the procedure.
If the headache turns out to be caused by a tumor, it may be either malignant or benign. If it’s benign, your doctor may decide to leave it alone. A malignant brain tumor may be treated with surgery or radiation, especially if it’s detected at an early stage. If the tumor is isolated in one spot, a new technique called stereotaxic surgery can be used. Stereotaxic surgery is less risky than traditional surgery; special microscopes and new imaging techniques have made it possible for surgeons to work in areas of the brain that contain critical and risky neurological pathways.
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