Just a few things that strike me (as a physician) on hearing about your headache. It is very unusual for a woman to have onset of her migraines after age 50. Anyone that age with the worst headache of their life not only needs a CT scan of their head but, if that is negative, also a lumbar puncture (spinal tap) to rule out a small subarachnoid hemorrhage. People (especially women in their 40s and 50s) can have small aneurysms in their brain blood vessels that can begin to leak a little and cause a terrible headache -- yet nothing shows up on CT or even MRI. Only a spinal tap would show the red blood cells in the spinal fluid. These small "warning leaks" can sometimes come before bigger bleeds (larger subarachnoid hemorrhages) and thus present an opportunity to prevent a more serious problem. Since you are too old for onset of migraines (and you have to have more than just one for it to be a migraine anyway) I would make very sure that your neurologist knows you are concerned about the possibility that you had a warning leak and may have a small aneurysm (some are too small to be seen on MRI). Now you may not have any of this, but it would be a shame to gloss over it when it should have been investigated. The problem is that the blood in the spinal fluid starts to break down after a few days, so I don;t know that a lumbar puncture would help at this point. You can look for what is called xanthochromia (coloring of the spinal fluid from when the red cells bust open), but even that only lasts for so long. Ask your neurologist. But do NOT just blow this off as a migraine. Don;t worry, just see this through. And in the meantime don;t do any weightlifting or other type of straining. Hope this is helpful.
I am so glad for your posting. I also feel that it is rather odd to experience migraine for the 1st time at 52yrs. As a result of the MRI, my neurologist called to say that he detected a "small change" in the white brain cells which indicates migraine? Is this accurate...as I've said, I've never had a migraine headache prior to this. To the contrary, I've never had a bad heachache, period. I'm not sure what kind of "change" could be visible, especially since this was my first episode. I explained my concerns when I initially saw this Dr. and indicated that I wanted to ensure that there were no other issues involved. He also gave me a prescription for blood work "which would indicate migraines". I'm having this blood work done tomorrow as well as the carotid study he requested in addition to the MRI, as I did make it very clear that I wanted to explore all possible causes. I will remember your advice as to the spinal tap in the event I experience this again. While I don't approve of self-diagnosis, I do have gut feelings about my basic health when things just don't seem 'right'. Again, thanks for your post and support. You've given me the push to examine this a little further. Best Wishes for a Happy Healthy New Year.
As far as I am aware, there are no changes on an MRI to indicate migraine (if there are it is something ultra new, because I read all the journals about migraines and have had my own MRI for migraine when my headaches increased in frequency and severity). And I do not know of any blood work that would "show" a migraine. He may be checking an erythrocyte sedimentation rate (ESR) which is a general indication of inflammation and is elevated in temporal arteritis, a connective tissue disease that affects the temporal arteries -- they are inflamed; this is diagnosed by biopsy; treated by steroids. Can;t really think what else he might be checking other than maybe some lipids (cholesterol, etc.) in case he thinks you have cerebrovascular disease (which can lead to stroke). Get on him about the berry (that's what they are called - berry) aneurysm thing -- that you are concerned that severe headache could have been a warning leak from a berry aneurysm and how can that be addressed? The only way really is cerebral angiography (squirt dye into the arteries in your brain) which has some slight risk but is able to show smaller aneurysms than MR angiography as far as I am aware (I could be wrong - you might want to ask the resolution of MRA (MR angiography) vs. traditional cerebral angiography.) So this guy is a neurologist? Keep me posted on how you are feeling and how your work up is going.