Should i get a second opinion on headache? can they miss an aneurysm on ct? i have had migraines and tension headaches my entire life. yesterday i was awoken and the second i sat up my head hurt worse than anything i have ever experienced. none of my norm

I : I can not tell you the reason for the change in your chronic headaches. But i will explain, that in the emergency room, a lot of times a big part of the focus on seeing someone with the worst headache ever, is to rule out the most serious causes. It sounds like they took your concerns seriously because they obtained a ct scan. What i recommend now, is that you contact your doctor. Your doctor will know your medical history better than a doctor who sees you in a one time er visit. Your doctor is in a position to also be able to see you for follow up visits if you require an extended evaluation and to ensure your conditions are responding to treatment. I wish you well.

In : In answer to your question about aneurysms and ct: when a patient presents with a really severe headache, we do a ct to look for evidence of bleeding. Ct is very sensitive to this, independent of finding an aneurysm. If there was no blood on that ct, then a ruptured aneurysm is not a very likely explanation for your pain. As far as ct's ability to find an aneurysm--it's very good if you get IV contrast, and very poor if you don't. When looking recent bleeding, we don't use contrast, so you might not have been adequately screened for aneurysm. If, on the other hand, you did get contrast, then any aneurysm that might be present would either have been seen or be so small that it would be unlikely to be a problem.

See a doctor asap: If your headache pattern changes and/or you feel a sudden severe headache you should see a doctor right away. If you feel the worst headache of your life, that could be an emergency for which you should go to an emergency room right away.