Head pressure

[Gretkurl]

I have a meningioma that was 1.7cm X 1.2 cm last March.  It was found in March 2006 and has grown about 1 mm each year.  It is just above and behind my right ear near the 7th nerve.  For the last six weeks I have felt like I have been wearing a hat that is 3 sizes too small.  I have pressure pushing from the inside of my head wanting out.  The last two weeks I have also had occasional right ear pain.  I saw my N two weeks ago and he recommended we try some meds.  I told him that I am a root-cause person not interested in masking symptoms so he said when I couldn't take the pressure he would do an LP to see what my ICP was.  My next MRI is in March.  I have been fully functional but have taken Aleve almost daily and have had trouble trying to exercise as the pounding while running or doing aerobics is too much.  Should I do the LP, try some meds, or get another opinion?

[Daniel M Prevedello, MD]

Dear gretkurl

I agree. I will be glad to review your MRI in March free of charge if you want.

[Gretkurl]

Thank you for the info.  I am 43, female, active, low-normal BP, pulse of 45-50 most of the time.  I have decided to forgo the LP right now.  I'll see what the growth is in March and make the surgery decision then.  I went to my PCP to check for any other potential causes for the headache and found out both eardrums were impacted.  After flushing and cleaning, most of the headache has subsided for now.  Goes to show me that I shouldn't assume zebras when I hear hooves, but horses.

[Daniel M Prevedello, MD]

Dear Gretkurl

Well, we have a tumor that is growing slowly, but it is confirmed: it is growing. Now you are having symptoms. The LP can be done, but independent of the result something needs to be done. If it came normal you know it is directly from a growing tumor, if it came high then we also know is related to the tumor.
I think it is a decision that depends on your age and other problems of Heath. I don't know how old you are. If you are heathy and young, surgery is probably the way to go with no much anxiety.
Radiation or observation with pain management in the other scenario.