I was wondering if I could get some advice. I am 32 yrs old and have had Epilepsy since I was about 14. It is well controlled though when I do have seizures they are grand mal. It has been over three years at this point since my last one.
My mother is 51 and in 2001 had surgery for an acoustic neuroma, then a few years later had radiation for it and now, just on Monday Oct 27, had a cerebral aneurysm clipped. She has had her share of brain surgeries!
Now, to get to my question. In the last couple weeks two seperate occasions I have felt a sharp pain above/behind my left eye. It went away within a couple seconds and left no side effects behind, no headache etc. but I am wondering if I need to be concerned about it? Are aneurysms genetic? Obviously my family has a history of neurological problems. I have not had an MRI in years for my Epilepsy. I do not get headaches often though the eye pain in the last couple weeks has gotten me thinking. What could it be?
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without being able to obtain a detailed history and examine you, i can not tell you what is the cause of your headache. However, I will try to provide you with some general information.
Regarding your headache, this is a very common symptom, and most of the time there is nothing underlying the headache, specially if there is no neurologic deficits. However sometimes headache can be a sign of a serious condition, for example subarachnoid hemorrhage which presents as the “worse headache”, or meningitis which is a manifestation of infection and the headache presents along with fever.
Headache may also represent a primary problem with no other underlying condition, and examples of these are migraines, or other headache types carrying names like paroxysmal hemicrania or cluster headache. The diagnosis should be correctly made as the treatment will be different.
Sometimes headache may be related to sinus infections, ear infections, eye problems, or other conditions not directly related to the brain, and an appropriate diagnosis should be made.
Aneurysms are a very important condition that could be lifethreatening, and they are caused by weakness in the vessel walls leading to dilatation. There are different types of aneurysms and they could be caused by different conditions like infections, radiation, trauma, or even genetic conditions. Some aneurysms are familial, and in these cases, family members may need screening for aneurysms, which is done by CT angiography or MR angiography, and if needed, a conventional cerebral angiogram. Some conditions associated with higher frequency of aneurysms are Marfan syndrome, Ehlers Danlos, Polycystic kidney disease or other collagen vascular disorders.
In your case, I am not sure if the aneurysm that your mother had is a familial type, or if it is related to an intravascular infection or other underlying problem. If it is a familial type, screening for family members may be considered.
I am not exactly sure what the cause of your headache was, however self limiting headache for few seconds, with no neurologic deficit is usually nothing to worry about, unless there are risk factors for some intracranial conditions like I mentioned.
As you describe, you have a history of epilepsy, and you still have seizures.
If you are concerned, I think you should have a discussion with your neurologist to determine if an MRI for imaging of your brain, and MRA or CTA to screen for an aneurysm is reasonable or not. The discussion should take into account the cause of the aneurysm in your mother. The discussion will also help to determine what is the cause of the headache you had and if further testing is needed.
As I said, without being able to obtain a detailed history and examine you, I cannot tell you what you have, or if you should have further imaging or not, but I think a detailed evaluation and discussion with your neurologist may be helpful. I hope this information is useful.
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