I have noted that the patient is a lady aged 61 years with a history dating back 20 years. Since she also throws up as soon as she gets this headache, this appears to be a case of vascular headache. I suggest that she can use tablet desval ER 500mg 1-0-1 every day for 3-4 months and consult the local neurologist. If her heart is normal, then she could use suminat nasal spray just at the onset of headache one or two puffs for each nostril. This would definitely give relief.