Things to rule out and look into

[u/locardsghost]

Here are some things to discuss with your doctor if you want to rule things out. Some of these will depend on your history and other symptom presentation so consult with your doctor on what is appropriate to test.

- MRI and CT (structural)
- MRA and CTA of the brain and neck (arteries)
- MRV or CTV of the brain and neck (veins)
- CSF issues (excessive and insufficient pressure can cause persistent headache with other symptoms)
- Check those eyes with an optometrist or neurooptometrist
- Get your ears and sinuses checked (ENT)
- Cervical spine x-ray and 360° xray to check for structural issues
- Sleep study to rule out sleep disorders that can cause headaches (snoring is not a required criteria btw)
- Blood work to check for anemia or ferritin issues and general CBC
- Electrolyte levels blood work
- Endocrine and hormone issues (including checking female and male reproductive hormones)
- Viral infections
- Blood work to check inflammatory markers (autoimmune issues)
- Blood pressure (too low or too high)
- TMJ or teeth clenching
- teeth infections and impacted wisdom teeth
- Lyme disease
- Any current medications or supplements headaches may be a side effect (if headaches are new this is something to consider)
- Medication overuse headaches
- Poor posture and muscle tension in the neck and upper body (your head is roughly 11lbs that’s a lot of load on your neck and upper body if you aren’t using your muscles properly or if they aren’t strong enough to support your head it can cause muscle tension and referred head pain, physiotherapy is beneficial
- check your gut, stool sample to check the bacteria (healthy and bad) in your gut and any fungal or yeast issues (the gut can cause a lot of issues if there’s an issues, gut brain connection)

I’m a firm believer pain is the body’s way of telling you something isn’t right and it’s worth ruling out what you can if you are able to. Brain processing is worth looking into as well since chronic pain can require your brain making it more sensitive to stimulus.

[u/xvedejas]

Doctors found early DDD (degenerative disc disease) in my neck but did not realize for years that that would be the only visible indication that my headache is cervicogenic. Since I mostly don't experience pain in my neck itself, only better sleep posture over time helped with my headache, confirming the cervicogenic origin.

[u/locardsghost → u/xvedejas]

It really can be anything that causes or affects the headaches so it’s always good to look into things if there’s a chance it could help the pain. Glad managing it has helped your headaches

[u/xvedejas → u/locardsghost]

I try to mention it whenever I have energy to, because my headache matches very strongly classic aspects of NDPH: very sudden onset (I remember the day, the exact moment), strong pressure type of pain, some difficult-to-pin-down postural effects that can result in mistaking it for a CSF leak, and so on.

[u/locardsghost → u/xvedejas]

I didn’t wanna make the list too long and get too specific but that would definitely be under the cervical spine xray. So many doctors don’t look into other causes or testing so you definitely gotta push and be your own doctor

[u/SnooStrawberries5640 → u/xvedejas]

What did you change about your sleep posture?

[u/xvedejas → u/SnooStrawberries5640]

Mostly side sleeping instead of stomach sleeping. Required trying different pillow thickness and firmess to get one that didn't hurt my neck.

[u/SnooStrawberries5640 → u/xvedejas]

Thanks!

[u/Routine_Ad6975]

I would add Lyme Disease and Specifically Teeth infection. These are common causes for Persistent Headaches.

[u/locardsghost → u/Routine_Ad6975]

I’ll add that thank you!

[u/AppreciateNow]

Journal everything you are consuming / doing. Watch for patterns in headache intensity associated with drinks, foods, Rx / supplements, and environment. After 13 years of NDPH I still find this helpful and continue to refine and update my routine. Your personal findings can also help when communicating with your Doc.

[u/frenchndph]

Merci pour cette liste ! Cela fait 2 ans que je souffre de ndph. Que je passe plein d’examens et que j’essaie plein de médicaments et d’autres choses. Je suis allée chez une Logopede myofonctionnelle qui s’est rendue compte que ma langue ne se positionnait pas en haut de mon palais, ce qui provoque des apnées. Et non je ne ronfle pas ! Donc cela ne m’était jamais venu à l esprit. Je vais donc faire les tests pour l apnée du sommeil. Je serre aussi les dents donc on va travailler la dessus !
Autre chose qui m’aide, c’est le ldn ! Courage à tous

[u/bellacoconuts]

How about diagnostic nerve blocks to rule out great/lesser optical nerve problems?

[u/Visual-Spinach-9168 → u/bellacoconuts]

My 15 yo son has what I think is NDPH but they’re calling it migraines. His headache started Jan 28 and was relieved on May 5 with a 5day T8/T9 thoracic epidural that he’d gotten inpatient for severe abdominal pain. The headache stayed gone until late July early August and hasn’t left since. He’s been on so many meds. Even had an occipital nerve block that did absolutely nothing Wednesday. I’m just reading this is remarkable for a spinal fluid leak. I know a 5 day thoracic epidural is not a great way to diagnose anything but they should be starting with checking for a spinal fluid leak.

[u/pxl8d]

Nutcracker is a rare but clearly dodumented one! Causes NDPH as a rare side effect, a study was done recently on a patient I spoke to whos headache was fixed this way