The MRI with contrast is to see if their is any bleeding on the brain.Since this is not the cause of the pain,you wont see anything.I started having these pains at the top of my right ear 3-4 years ago.Two or three times a year and would last from 4-8 hours.Thought i was sleeping wrong.Maybe on my hand or something.Then 3 months ago it lasted for 3 days.Had the MRI with contrast just in case.I was glad to know other people had this condition.Not that I want others to suffer,just relieved it was treatable.I never really had headaches,I have never had a migrain,and from what Ive read only about 1% of the population and thats almost all males over the age of forty suffer with (ICEPICK) headaches.Theres to much to list as to what medical professionals think what triggers them.Notice I said,what triggers them, not what cuases them.Most will agree their in the migrain family related more to cluster headaches.Same thing happens, blood vessels swell and put pressure on nerves.With people who truly have icepick headaches,unlike clusters their timing is not reliable.True clusters can almost be predictable by the patient.Icepicks can come and go at will.Im really glad I dont have this condition as much as others do.I feel sorry for anyone who suffers from this on a chronic level.There are meds that you can take,your Doctor can prescribe.Very similar stuff for treating migrains.And yes,the pain is severe enough to wake you from deep sleep.It happens to me,and I dont know why Im awake, until about 5-10 seconds later when the next jolt hits.You will never be able to explain it to anyone that hasnt eperianced it.I know pain,I have broken my collar bone,both hands,my right ankle,also ruptured my left eardrum and had at least 50 stiches.I hope you who read this got something from it.It scared the &%#^ outta me! Just glad Im not going to die from it.Its also known as (alarmclock headach) and my favorite,the (suicide headache).