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Neurology (Expert Forum)
daily headache syndrome, or meningioma
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daily headache syndrome, or meningioma
by Qzar, Dec 30, 2005 12:00AM
Hi, I have been experiencing what I would call chronic daily headache syndrome. Also, vertigo and delirious feelings are frequent (by delirious I mean sometimes i have trouble recognizing the details of people's faces..my mind is out of focus with my vision). Most days the pain is a 5 out of 10, but can range from 3 to 8, the most important factor is that the dull ache never ever goes away. I feel the pain deep around my sphenoid sinus, but also along my forehead and the top of my head, as well as the occipital region to a less degree.
1st scenario)I do have a 3.5 centimeter mass on the MRI and its thought to be possibly meningioma. It's located adjacent to and just above my right orbit, it is fully outside the brain, and as my doctor said "it doesn't even penetrate the dura". I've repeatedly questioned him about this because it's the only thing found in scans of my head and neck, but he said he thinks it "extremely unlikely" the cause of my pain. I do not really feel pain "localized" to the area of the meningioma UNTIL I lay down on my left side of my head and then often I DO feel pressure which is very localized to the area of the meningioma. I have also had an MRA which releaved no aneurysms or occlusions or stenosis. EEG report was normal, but there was abnormal activity in the specific area of the meningioma.
2nd scenario)Lets say this meningioma is not the cause. I would like to explore all possibilities of my type headache, at any cost, please give me a list of every test you would if i were your patient (at any cost!) 1 year misery no answer! thanks!
1st scenario)I do have a 3.5 centimeter mass on the MRI and its thought to be possibly meningioma. It's located adjacent to and just above my right orbit, it is fully outside the brain, and as my doctor said "it doesn't even penetrate the dura". I've repeatedly questioned him about this because it's the only thing found in scans of my head and neck, but he said he thinks it "extremely unlikely" the cause of my pain. I do not really feel pain "localized" to the area of the meningioma UNTIL I lay down on my left side of my head and then often I DO feel pressure which is very localized to the area of the meningioma. I have also had an MRA which releaved no aneurysms or occlusions or stenosis. EEG report was normal, but there was abnormal activity in the specific area of the meningioma.
2nd scenario)Lets say this meningioma is not the cause. I would like to explore all possibilities of my type headache, at any cost, please give me a list of every test you would if i were your patient (at any cost!) 1 year misery no answer! thanks!
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jan 02, 2006 12:00AM
Meningiomas are quite common in the general population, particulalry as we get older. The majority are benign, and grow very slowly if at all. Nevertheless they should be kept under surveillance every year or two or if new symptoms develop.
They are commonly an incidental finding when scan are done for other causes like headache. Therefore it is not straightforward to attribute you symptoms to it
There are pain sensors in the meninges though and it could be an aggravtor or trigger of your headaches. You could have a primary headache syndrome ie tension or migraine headache that is aggravated by irritation of meningeal pain receptors in the region of the tumor. This is conjecture and unfortunaterly there is no good test to confirm where the pain is from. It could be proven to be the case if you have the tumor surgically removed and your headache disappearm but surgery involves open brain surgery and the risk might not be worth the benefit for a small meningioma.
Continuing care under a neurologist specializing in headache wouldbe important in deciding which is the most likely scenario, to diagnose a primary headache syndrome if present, and to break the chronic daily nature of the headache, review your medications and change them to avoid medication overuse headache. Once other serious pathologies are excluded by MRI etc, then the best tests are what works for the headache ie meds, botox etc - somewhat of trial and error unfortunately, but that is where a good headache doc comes in
Good luck
They are commonly an incidental finding when scan are done for other causes like headache. Therefore it is not straightforward to attribute you symptoms to it
There are pain sensors in the meninges though and it could be an aggravtor or trigger of your headaches. You could have a primary headache syndrome ie tension or migraine headache that is aggravated by irritation of meningeal pain receptors in the region of the tumor. This is conjecture and unfortunaterly there is no good test to confirm where the pain is from. It could be proven to be the case if you have the tumor surgically removed and your headache disappearm but surgery involves open brain surgery and the risk might not be worth the benefit for a small meningioma.
Continuing care under a neurologist specializing in headache wouldbe important in deciding which is the most likely scenario, to diagnose a primary headache syndrome if present, and to break the chronic daily nature of the headache, review your medications and change them to avoid medication overuse headache. Once other serious pathologies are excluded by MRI etc, then the best tests are what works for the headache ie meds, botox etc - somewhat of trial and error unfortunately, but that is where a good headache doc comes in
Good luck
Can i ask some questions
1 When and how did your headache start
2 HAve you had a full set of bloods done including lyme check, ESR and white blood count?
3 i live in the UK so am on the NHS. My neuro told me that Apart from MRI and MRA of head and neck and blood work up there is not alot else he can test and most headaches do notshow in tests!
4 HAve you seen an ostopath or chiroprator to check it is not related to a postural problem? HAve you tried accupunture?
5 do you have any other symtoms with the headache? have you found what seems to make them worse?
I do not know the answer to if yours is related to the meningioma as i am no doctor but the forum doctors here are very helpful but just thought that i to am suffering from a daily headache and would be interested to here how you get on and say you are not alone
James 22
I would encourage you all to read this thread. Myself and others have written extensively about this phenominon.