Case study: Headache and heartache

Case 1. Malformation and syringomyelia
A 21-year-old male patient JR attended an eye examination some 20 years ago complaining of ‘blinding headaches’ following prolonged periods of reading and with computer use. The headaches emanated from the back of the head and lasted for between 10 seconds and a minute. The headaches were frequent on a daily basis and none of the standard pain killers had helped. There were no symptoms of nausea and no visual aura. He had also been experiencing pins and needles on his right side accompanied by a loss of sensation. His headaches appeared more frequently when he suffered a cold and bouts of coughing made the back of the head and the shoulders hurt.