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Neurology (Expert Forum)
headache pain and aneurysms?
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headache pain and aneurysms?
by Mels22, Jan 26, 2007 12:00AM
Ok I NEED answers and if anyone has any, I would greatly appreciate it! I have had headaches for 11 days now. I am taking topomax and it doesn't seem to be doing anything. I am extremely fatigued. I sleep like 12 hours a night and then take several naps. I am a 26 year old female otherwise in good health. I do have anxiety and tend to think the worst so thats why I wanted others opinions. I have a baby to think about so I really need to get better. I had a CT, MRI/MRA on Oct 31st of 2006 that were clear but did show chronic sinusitis. I have called my neurologist and she didn't seem too concerned...I have an appt. next week. She did a BAER test yesterday which I'm not really sure what that will do. I have also had ear fullness and ringing in my right ear for a week now. My right ear has regular tinnitis and pulsatile tinnitis. I read somewhere that sudden tinnitis can be something like an aneursym or something. Do you think thats what it is? I also recently (2 days ago) developed pain behind and directly above my eyes - very painful! I also have a lot of pressure in the front of my head by my eyes - like a band of pressure. My questions are...
Do you think that anuerysms can develop that fast if my tests were clear 2 1/2 months ago? What else could it be? Should I seek ER tests soon? I'm very worried and any help would be GREATLY appreciated!
Thank you and God bless!
Do you think that anuerysms can develop that fast if my tests were clear 2 1/2 months ago? What else could it be? Should I seek ER tests soon? I'm very worried and any help would be GREATLY appreciated!
Thank you and God bless!
Doctor's Answer
by CCF-Neuro-M.D.-SH, Feb 14, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The headache that you describe are unlikely to be due to anueryems or other ominous pathologies. Anuerysms do not develop overnight, and most often are present for many years without causing and problems/headaches, then may rupture unexpectantly. The good news is that you did not have anuerysms on your MRA and thus you should not be concerned. MRA is not the best study for aneurysms, but is a good screening tool. If there is any thing suspicious on the MRA a CT angiogram can be done that look at contrast dye filling in the cerebral vessels. The 'Gold standard' is the convential angiogram, which is done when there is bleeding from an anuerysm(sub arrachnoid hemorrhage), to repair an anuerysm (through endovascular coiling, etc) or when other tests are unclear. Your headaches sound like a primary headache syndrome and are most likely in the migraine spectrum. I would recommend a MRV (magnetic resonance venogram) if you have not had one, since after pregnancy women are more prone to sinus venous thrombosis, which can cause headaches like you describe. Topamax is a preventative medication that works after 3-4 weeks of use, so I would suggest giving it a full trial. I think the BAER is a reasonable test to evaluate you complaint of tinnitus and ear fullness, and should also be accompanied with other tests of ear/vestibular testing, such as ENG. In the case you described, I would recommend a trial on Indocin (a strong anti-inflammatory medication) and possilbly a medrol dose pack (steroid taper). I would also caution against using to many over the counter pain relievers (tylenol, ibprofen, etc) because this can cuase rebound headaches.
I hope this has been helpful.
The headache that you describe are unlikely to be due to anueryems or other ominous pathologies. Anuerysms do not develop overnight, and most often are present for many years without causing and problems/headaches, then may rupture unexpectantly. The good news is that you did not have anuerysms on your MRA and thus you should not be concerned. MRA is not the best study for aneurysms, but is a good screening tool. If there is any thing suspicious on the MRA a CT angiogram can be done that look at contrast dye filling in the cerebral vessels. The 'Gold standard' is the convential angiogram, which is done when there is bleeding from an anuerysm(sub arrachnoid hemorrhage), to repair an anuerysm (through endovascular coiling, etc) or when other tests are unclear. Your headaches sound like a primary headache syndrome and are most likely in the migraine spectrum. I would recommend a MRV (magnetic resonance venogram) if you have not had one, since after pregnancy women are more prone to sinus venous thrombosis, which can cause headaches like you describe. Topamax is a preventative medication that works after 3-4 weeks of use, so I would suggest giving it a full trial. I think the BAER is a reasonable test to evaluate you complaint of tinnitus and ear fullness, and should also be accompanied with other tests of ear/vestibular testing, such as ENG. In the case you described, I would recommend a trial on Indocin (a strong anti-inflammatory medication) and possilbly a medrol dose pack (steroid taper). I would also caution against using to many over the counter pain relievers (tylenol, ibprofen, etc) because this can cuase rebound headaches.
I hope this has been helpful.
Thanks!!!!
Thanks!
http://www.medhelp.org/forums/neuro/messages/34656.html
Please be advised that my response to you is not professional, is not medical advice, is educational, and that I am not a representative of MEDHELP.
With that stated I see actually a possibly simple answer and that would be sinus induced tension headaches. MRI studies would have caught an anuer, et al, possible causes.
I am sorry that I could not be more helpful, but I think that the answer is probably viral/sinus/tension head ache.
Good Luck!
JCmcc.
Have you just had a baby? Sometimes, women can have blood clots in their heads around the time they're pregnant and that can also create increased pressure.
Having said that, chances are these are just bad migraines, maybe superimposed with some sinus problems that you might be having. Talk to your internist about that, perhaps, he'd give you an antibiotic or a decongestant to try out.