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Vascular Headache.

Resolved Question:

I have a swollen temporal vein, leading from my ear to the top of my head. It is very tender to touch all the way along the vein. I noticed it 2 days ago after a neck massage (I am unsiure how long it's been there are it only hurts when touched). I have no headache.

I am 40 and worried about Temporal Arteritis. Though I have read it is unlikely I have also read of many cases at my age. If it wasn't this what else would cause these symptoms?

I have also been experiencing night sweats for the last 6 weeks, and have been diagnosed with an enlarged spleen.

Category: Rheumatologist

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Category: Internal Medicine Specialist
Dr. Bimlesh Dhar Pandey is online now

Expert:  Dr. Bimlesh Dhar Pandey replied 4 Days.


Thanks for the query at DoctorSpring.

Temporal arteritis is unlikely in your cases , especially since you are <50 yrs of age. I feel your symptoms are more likely to be vascular headache. You can take a OTC pain medication like Ibuprofen twice daily and see whether it aborts your headache.

If there are any eye symptoms or persistent pain you need further evaluation. To rule out temporal arteritis for sure you need to alteast get a ESR and CRP done (both blood tests easily available).

There are specific investigation like USG and doppler study of temporal artery, but those are not required at this stage. For now if the pain persists please get ESR and CRP done. If there are eye symptoms get medical help without delay. Please do update me with the reports.

Feel free to ask followups
Thank you


Patient replied :


Thanks for the reply, though sorry if I didn't make it clear - I have no headache at all. Just pain on and all along the swollen vein when touching it.

When would make this one vein inflamed?

Asprin does not remove the pain. I had some bloods taken a few weeks ago for my nightsweats, I will see if I can get the results.

Expert:  Dr. Bimlesh Dhar Pandey replied 3 Days.


Sorry I missed that point - Absence of headache makes Temporal arteritis even less likely. That means there is no emergency. The swollen artery could be due to a local arteritis (infection / unnoticed trauma / rarely immune mediated) . It will be better if you can confirm the vein swelling from a Doctor ie, whether it is a vein or temporal artery which is swollen. Veins can swell up for a number of reasons and most of them are non specific and non significant. On the other hand artery swelling is rare.

In view of the night sweats it is better to get a baseline tests done. Do share with me the reports you have (if possible). I will suggest other tests if needed.

Do note that the aim here is not to get a diagnosis, rather than rule out any significant disease at first.

Hope this helps
Thank you

Dr. Bimlesh Dhar Pandey
Category: Internal Medicine Specialist
Senior Residency: Rhematology, All India Institute of Medical Schiences, New Delhi, 2009
Post Graduate, Junior Residency: MD (Internal Medicine), Rajendra Institute of Medical Sciences, Jharkhand, 2006
Residency: Physiology, Institute of Medical Science, Banaras Hindu University, Varanasi, 2003
Internship: Government Medical College, Trichur, 2001
Medical School: MBBS, Calicut University, 2001
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