new headaches

[ingcam]

Hello, I wrote in a couple of weeks ago about passing out after taking imitrex nasal spray for a ? migraine.  I have had a MRI which showed a large pineal cyst that is pressing on tectal region of my brain but not causing hydro.  My neurologist wanted me to see a neurosurgeon about this cyst but I declined.  We agreed on a 6 month re-scan to re-evaluate the area.  My neurologist told me that there the area has gotten bigger and there is splaying of the veins above my Pineal gland.  He positively insists on a surgical consult. He tells me that there is no more room for expansion without causing obstruction issues.  He also wants an eeg.  My question is could this cyst be causing the headaches.  they don't respond to the imitrex like the other headaches.  These headaches never really go away only lessen or intensify.  they are accompanied by a nausea that is causing weight loss.  Are there any new medications that might help me?  I have had one brain surgery for a cp angle cyst  already and really don't want anything else done. I have passed out twice and seem to be feeling worse every day.  thanks

[Vanessa Lacuesta]

Hi,

Your neurologist has noted a large pineal cyst on your MRI.At this point, we may not be able to tell if this cyst actually causes the headaches or not but an enlarging pineal cyst may be likely to cause symptoms .

I think this is something that has to be looked into.I understand that you are hesitant to undergo another surgery but  progression of your symptoms and its non response to medications  do require further evaluation.

I hope I can help more.

[ingcam]

Dr. Lacuesta,
I do not have hydrocephalus.  What is causing the headaches?  

[Vanessa Lacuesta]

Hi,

I know that this is a difficult time for you but your condition warrants immediate intervention.

A pineal cyst is usually asymptomatic until it enlarges and compresses nearby structures. I suggest that you heed your physician's advice and seek a surgeon's consult immediately. A large pineal cyst causes a "mass effect" that may contribute to the headaches.

See the surgeon and keep us posted with your progress. Be positive and try to deal with this a step at a time.