Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Constant 'Pressure' Headace w/ Right-Sided Weakness Thank you in advance for your time. I was involved in an auto accident on 1/31/98. I was diagonised with a severe cervical strain. However, since then I have had a constant pressure in the back of my head which sometimes (3-4 times per week) gets so severe that I cannot function. I have also suffered right-sided weakness, especially in the arm and hand, I can't walk more than .25 mile without my right leg going numb and I have to drag it. I also have swelling in my right eyelids. I have had MRI of head and neck which showed minimal disc bulging or osteophyte formation at the C5-C6 level. I have also had carotid arteriogram and EEG which were 'within normal limits'. I had a spinal tap and the doctor said the pressure was 'high' at the time. The tests on the fluid showed: MBP of 1.2, ANA of 15.0 and speckled pattern, protein of 61, uric acid of 5.1, and RBC of 2. Blood test done at the same time showed a sedimentation rate of 18. I have been on numerous NASID medications, pain killers, and have had 4 (four) ocipital nerve injections. All of this brought only minimal relief. I am currently taking DHE45 injections when the pain gets bad, but it only makes it tolerable. I hope someone can help to give me some advice. My doctors really don't seem to believe me, and I know that this is not normal for my body to be like this. My only prior medical problems were several laser surgeries for endometrosis, and I was diagonised 2 years ago with fibromyalgia.
Dear Kelly: Sorry that your having all these symptoms. It is difficult for me to assess you over the internet but I think you may have what is called occipital cephalgia. It is associated wtih cervical cord problems and presents as you describe. The only medication that I know that works for this type of headache is indomethacin. We will try lidicaine injections which sometimes helps. I would ask your neurologist to see if a trial of indomethacin might help you head pain and eye swelling. I am not sure why you have the right sided weakness as the description of the MRI doesn't seem to indicate that the C-spine was that abnormal. However, if you push it an EMG might give your neurologist a better feel for what might be causing the right upper extremity weakness. The leg weakness is not due to the C-spine problem, so I am at a loss for your leg problem. I hope the information helps. Sincerely, CCF Neuro[P] MD | |
