The headaches centre mainly in the forehead and occiput. Dull, gloomy, confusing pressure in the brain; the head feels stupid, dull, as if drunk, as if compressed or screwed in. Pressive pain in right frontal eminence.
A lot of pulsating or stitching headaches, very violent; extremely painful beating in the cerebral arteries. Congestive headaches, with internal heat in the head, even sensations of burning, with ebullition and roaring of blood in the head, also with humming. Violent stitches through the whole head: in the temples, especially with every effort at mental exertion; in the occiput, in the vertex; also at the outer part of the head. ‘Throbbing in vertex, intermingled with stitches, in paroxysms.’ Boring pain is also frequent.
A painless ‘digging’ in the whole head.
Headache at night as if an ulcer were inside.
A key-note is a painful sensation as if a hollow space were between the frontal bone and the brain. This symptom has been confirmed in a lot of cases, also in recent times. It may also be described as follows, as in one of Keller’s cases: ‘When I’m looking up after having written or looked fixedly at one spot, I get a giddy feeling, I feel as if all the blood was running down into the lower limbs and nothing remains in the head. It is as if empty in the head, there seems to be a big hole in the whole frontal region, and a hollow space above the eyes, and then a slight headache comes on.’ This peculiar sensation is ameliorated by warmth.
The scalp feels very tense and tight, and it is sore to the touch. ‘Pain on a small spot of the vertex, as from a blow or beat, only on touch.’
Itching on hairy scalp. Tinea capitis in the occipital region.
Involuntary motions of the head, nodding, turning from side to side, etc.; often preceding an epileptic or choreatic attack. An aura symptom may be a hot and sweaty head.
Eyes
A very characteristic symptom is a paralysis of the eye muscles, particularly if caused by exposure to cold. The lids feel extremely heavy, so much so that the patient can hardly hold them up or open them. They might close involuntarily, or, even more characteristic, one lid droops (ptosis).
Diplopia from paresis of the nervus abducens of one side; if she looks to the affected side, double vision comes on; to prevent this, she turns the whole head