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Recurring headache in one spot on the left side, but had a clear MRI last month?

So, as a brief background, I'm a 35 y/o female. Back in October I had the worst headache of my life as I was experiencing an orgasm. It spanned the whole back of my head, from ear to ear, so while it was scary, I didn't feel like it would warrant a trip to the ER. It lasted an entire evening, dulling only slightly as the night progressed, but returned in a more mild form the next day as I was bracing myself against the wind. I also had some pulsile tinnitis that was going through for several days after. I made an appointment with my primary care doctor about it, and I got an MRI at the end of December (delayed due to problems with scheduling).

The MRI came back clear, but over the past few days I've started experiencing a headache on a single spot on the back left portion of my head. It's mild, though  occasionally gets up to a moderate intensity for a brief moment, comes and goes, but it's always that one spot. I  can't figure out triggering events, as it always seems to occur at random moments. I've been having sinus issues, but this feels way too far back to be sinus. The only other innocuous thing I could think of is that it's somehow muscular, as my neck and left shoulder muscles have been incredibly tight in the past, and the headache hovers right at the top of where my neck muscles are attached to my skull (near my occipital lobe).

I don't want to go back to my doctor for something that's not "serious," and I definitely don't want to go to the ED unless I absolutely have to, and all Google searches do is make me anxious. Any insight would be greatly appreciated!
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Avatar universal
Doctors are smart & idiots at the same time.  Headaches and migraines baffle them.  If you  can, go to a neurologist that specializes in headaches.  It is kind of process of elimination.  When I first started having migraines (and still) they are on one side.    It feels like someone jabbed me in the inside corner of my eye with an icepick.

Over the years I've actually found many triggers and causes.  The first  was the occipital nerve which runs from the spot you are describing to your face and can be pinched just like any other nerve.  I quite literally would get shots in the back of my head called "occipital nerve block" and that would instantly take away the migraine.  (That  would be my layperson first guess for you)

As years went by migraines changed in nature except always on right side.  I just learned that sinus issues are also a problem.  1/4 of a zyrtec at night and I have migraines far less frequently.  Don't get me going on fragrances.  instant intense pain.  Kind ofmakes me feel sorry for dogs and all the smells they have to deal  with.

Occasional headaches are just kind of normal and no one knows why.  Frequent headaches or intense headaches always have causes even if the doctors don't have the common sense to figure it out.  (It is a LONG frustrating process and you may need to see multiple docs before you find one that has a lick of common sense.)
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