Case of congestive headaches

A patient came with complaint of headaches. There was a sensation on congestion in head like blood filling up, the BP was high. It seemed a case of BP migraine where glonine should be useful.
I asked patient what makes it better. The patient said it gets better after passing stools, the patient also drank a lot of water with food and had a dry mouth.
Used to get sudden bouts of anger with face turning red and also lips getting red.

Headaches improving after passing stools is typically aloe.

Some headaches like this which are worse during straining can also be subarachanoid bleeding.
Her CT was normal but in many such cases the CT after 7 days is normal, the best way to diagnose is of course a lumbar puncture and look for xanthochromasia or RBCs in the CSF, however patient did not want to do that.

I was quite nervous here since the patient could be having a bleed and also seeing the high BP it was scary.
I still followed the modality of migraine better after stool and associated with anger, patient craving for water. Gave aloe 200c 4_0_0. After 3 days the migraine went away and the BP is also normal.

Note :

  • Aloe is a stimulant laxative, it moves the gut. It also at the same time dilates cardiac vessels, lowers vessel wall inflammation and stops bleeds. I am sure this case had a bleed but due to a lack of lumbar puncture cannot prove it.
  • The differentiator with pulsatilla for congestion is that pulsatilla patient has lack of thirst and no improvement after stools.

  • Gelsimium patient is not better after stools but afrer urination.
  • Sepia patient has improvement after vomiting.