Complicated Migrane(migraine)???

    
      Re: Complicated Migrane (migraine)???
    


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Posted by CCF NEURO MD on May 05, 1997 at 00:54:38:

In Reply to: Complicated Migrane (migraine)??? posted by D. on May 01, 1997 at 17:21:25:

: I have had a stiff neck and severe headaches for years.  No doctor has been able to help - and no medications (except narcotics) help the pain.  Recently I woke up in the morning with blurred vision, unstable gait, slurred speech, poor short-term memory, etc.  I thought I had a stroke (I'm ONLY 31!).  A cat scan and an MRI both showed what appeared to be an old head injury, scarring.  Supposedly it looks like it was a hematoma or brain hemorrage.  I was told there's not way of telling when this occurred or why.  What I'm wondering is, was this necessarily caused by a head injury?  Could it have been brain damage from drug use?  I used recreational drugs for about a year or two (esctasy) and am very concerned that I may have damaged myself more than I know.  Does anyone have any information???  Should I be concerned about this old injury causing problems in the future?  
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The first problem you describe, chronic headaches and neck pain, sound like tension type/ muscular contraction headaches.  They can be precipitated by an injury, stressful situation, arthritis in the neck or just occur for no reason.  These are a number of ways to treat these headaches with nonsteroidal antiinflammatory (motrin, ibuprofen, etc) medication, muscle relaxers, tricyclic antidepressants, Midrin and serotonic reuptake inhibitors (ie Zoloft, Prozac), among others.  I do not recommend narcotics as they are addicting.  A good exercise program to improve neck posture and flexibilty is also useful in conjuction with medication.  I would recommend seeing a neurologist who specializes in the treatment of headaches if you have not already seen one.  
The second headache you describe may have been what neurologist refer to as a complicated migraine.  This means that there were neurologic deficits associated with a migraine headache,  The symptoms are often self limited and do not recur.  This does not mean you had a stroke.  Treatment to prevent these headaches is recommended.
The third problem is what someone has referred to as a old brain hemorrhage.  There could be a number of causes and as you mentioned, it is difficult to date the onset of the hemorrhage based on imaging studies.  Hemorrhages can sometimes be silent if they are small.  The causes can range from an injury that occurred at birth to the use of drugs.  Birth injuries are called periventricular hemorrhages. They are more frequent in premature infants.  If you sustained a head injury as a child/adolescent with associated loss of consciousness, injury may have resulted.  In addition there have been reports of brain and subarachnoid hemorrhages which have been related to the use of ecstasy and cocaine.  Ecstasy can have some long lasting neurologic sequelae including, depression, anxiety, impulsive or aggressive personality disorders. It causes neuropsychiatric symptoms based on the damage it causes to the brains serotonergic neurons.  Although I did not see headaches listed as a side effect of this drug, it has been well recognized, the influence of serotonin in headaches.  There is no future risk for hemorrages from prior ectasy use.  However, there may be some changes with the personality as listed above.  It is unfortunate that so many illicit drugs are labelled as being safe when the side effects are not fully recognized.  I recommend discussing your use with your physician so that the best treatment plan may be made to get you back to feeling good.