Arterial head pressure

[jochastain]

At my wits end, 68 year old female.

No doctor has diagnosed the tremendous arterial pressure I feel in my head.  Its so bad by evening that I am sure blood will start spurting out my nose.  I feel like a stroke time bomb.  

There is NO pain.
    
Also extreme, constant bruit drives me crazy.  

All tests, MRI, MRA, CAT seem fairly normal.  Brain MRI does show some foci, but not increased from 5 years ago.  

15 years ago a Lupus specialist treated me with massive pulse treatments for vasculitis.  He is now dead, and I do not know HOW he diagnosed vasculitis.  

Now, no Rheu. or Neuro.  seems to have any idea whats wrong, and say tests don't indicate high blood inflammation.   However, I am a walking example of inflammation such as arthritis, lupus and asthma.  I believe I have vasculitis again.

I read a Mayo report that indicated some vasculitis victims do NOT show high blood inflammation on tests, since the arterial inflammation is in patches in the lining and doesn't always dissolve into the bloodstream. Does that make any sense?   If so, what TEST whould confirm or deny vasculitis in me?

Incidentally, shots of prednisone last month into my heels (by Podiatrist) COMPLETELY ALEVIATED THE HEAD PROBLEM FOR A WEEK OR SO!

BP has been real high, but is now down to 120/75  by 3 medications.

Enlarged thyroid was removed 6 months ago, but had no effect on this pulsing hammer in my head.

Carotid ultrasound indicated  blood circulating normally for my age, although left carotid is torturous, he felt it did not cause this pressure.

[Kevin Pho, MD]

I agree with the comprehensive workup thus far.  Many of the major diseases would have been ruled out already with the imaging tests that you have done.

You can indeed considered arteritis or vasculitis.  An elevated sedimentation rate can be done to exclude this.  If elevated, a temporal artery biopsy can be discussed to exclude this diagnosis.  The fact that the symptoms responded so well to prednisone also suggests an inflammatory etiology.

This option can be discussed with your personal physician or rheumatologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[jochastain]

Thank you for responding.  Please comment on this paragraph of my inquiry:  
"I read a Mayo report that indicated some vasculitis victims do NOT show high blood inflammation on tests, since the arterial inflammation is in patches in the lining and doesn't always dissolve into the bloodstream. DOES THAT MAKE ANY SENSE?  "

Based on my symptoms I have vasculitis, yet apparently the CR test is within normal range.   I self-medicated with 10mg prednisone 5 days last week and felt 'cured'for those days... However I feel a self-medicator in this instance has a fool for a patient.    

Is there a test besides biopsy that would confirm or deny this?   I don't want to submit to that.  I have Von Willebrands and many other disorders.

What other disorders should I research?

My local Rheumatologist and family doctor refuse to treat me, but admit its probably vasculitis.  The local ER refused to treat me.  I've searched this whole year for treatment, but Vasculitis specialists are scarce in Atlanta and have 3 month waiting lists.