Headaches

[Marianna88]

I"ve been experiencing different types of headaches for quite awhil but starting yesterday I experienced a sharp pain in my left eye and i'm nervous it might be an aneurysm. I had a mra about 2 years ago and it was normal. Could i possible have an aneurysm. Also my left hand got a shotting pain to day and locked up. I nervous and scared. Could you please let me know if this sounds like an aneurysm.

[Lama Chahine, MD]

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.

It sounds like you are having headaches with eye pain, and that you had an MRI which was negative. I can not comment on the cause of your headache/eye pain, but I will try to provide you with information.

It is understandable to be concerned about aneurysms or other causes of a headache, but it is also important to understand that after a headache has been adequately worked up with imaging, physical examination, and by history taking, a diagnosis of primary headache disorder can be made. There are several causes of headaches. Headaches can be divided into primary and secondary. Primary headache disorders are headaches without a direct cause. Secondary headache disorders are due to an underlying problem, such as a tumor, aneurysm, medication side effects, central nervous system infections, clots in the veins in the brain etc.

There are several primary headache disorders, over 50 different types.  For example  migraines, which usually a pulsating throbbing one-sided pain with nausea and discomfort in bright lights that lasts several hours. Another type is cluster headaches, which are sharp pains that occur around and behind the eye often at night and are associated with tearing of the eye and running of the nose. In primary stabbing headache, sharp or jabbing pain in the head occur, either as a single stab or a series of brief repeated volleys of pain. Primary stabbing headache often occurs in people with migraine.The pain itself generally lasts a fraction of a second but can last for up to one minute in some people.

As you can see there are many causes of head pain. Causes of eye pain are sometimes similar, however if you have VISION change, such as blurry vision, decreased visual acuity, double vision etc. it is important for you to be evaluated (by an eye doctor) for that instead of just attributing it to your headache.

Persistent eye pain associated with headache could rarely be related to clots in the veins of the brain or tears in the artery (called a dissection). This is usually associated with weakness or loss of sensation on one side of the body or the other, meaning there will usually be other symptoms besides just the pain. Please understand I am not trying to imply that I think you youself have a dissection.

If you continue to have headaches with a negative work-up (negative MRI/MRA), it is like you have a primary headache disorder. You may benefit from evaluation at a specialized headache center for evaluation by a headache specialist, who can then make recommendations to your local primary doctor or physician regarding management of your headaches. However, if you develop new persistent symptoms I strongly advise you to be evaluated by a neurologist just to make sure there is nothing else going on.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[Rob2008]

It sounds like nerve pain to me,   definately not aneurysm if the mRA was normal

[Rob2008]

generally you would have to have a huge aneurysm to have any ongoing symptoms

[Lengo]

I ned to know more about your symptoms, but I can tell you that headache pain that begins at the base of your skull, then continues mostly on one (but sometimes both) sides of the head, then into or under an eye could be C2 Radiculopathy, also known as Occipital Neuralgia.

I have this condition for years. It has gone undiagnosed. I've tried all remedies available, including phsical therapy, accupuncture, chiroptractic, medication therapies (including narcotics, and finally surgery, but the surgery was performed at the wrong place (C5-C6). During surgery recovery, I again went to physical therapy. My therapist said the problem lay at C2-C3, and that there was nothing more she could do. However, I was given a TENS unit, and it is working much better than anythng I've tried yet.

I suggest that you get a new MRI. If you've not had one for two years, then it is time for another.

Like the others, I doubt that you have an aneurism, but that is a reasonable suspect. However, I think that you'd be wiser to investigate C2 Radiculopathy and Occipital Neuralgia.

If you have the symptoms that I describe in the first paragraph, tell your doctor to suspect C2 Radiculopathy. If this is indeed the problem, you have options. Google "C2 Radiculopathy" and "Occipital Neuralgia" to find out what your doctors should know -- how to diagnose it, and your options for treating it.