26th February 2025

A 65-year-old woman presents to her general practitioner with headaches. She has been taking paracetamol

A 65-year-old woman presents to her general practitioner with headaches. She has been taking paracetamol for the past seven days, which has not helped. The headaches are bilateral and frontal, aching in nature and worse in the mornings or after taking her daily afternoon nap. The headaches generally last 60-90 minutes. She has also been feeling increasingly nauseous and has had morning vomiting for the last two days.

Her past medical history includes type II diabetes mellitus and metastatic breast cancer, for which she is currently receiving chemotherapy. Her drug history includes metformin 500 mg twice daily and carboplatin/paclitaxel chemotherapy.

On examination her observations are as follows: heart rate 76 bpm, blood pressure 128/72 mmHg, respiratory rate 16, oxygen saturation 98% on room air, temperature 37.0 degrees Celsius.

What is the most likely cause of her headaches?

Select the SINGLE most appropriate option from the list below. Select ONE option only.