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headache pain and aneurysms?
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headache pain and aneurysms?

Ok I NEED answers and if anyone has any, I would greatly appreciate it!  I have had headaches for 11 days now.  I am taking topomax (topamax) and it doesn't seem to be doing anything.  I am extremely fatigued.  I sleep like 12 hours a night and then take several naps.  I am a 26 year old female otherwise in good health.  I do have anxiety and tend to think the worst so thats why I wanted others opinions.  I have a baby to think about so I really need to get better.  I had a CT, MRI/MRA on Oct 31st of 2006 that were clear but did show chronic sinusitis.  I have called my neurologist and she didn't seem too concerned...I have an appt. next week.  She did a BAER test yesterday which I'm not really sure what that will do.  I have also had ear fullness and ringing in my right ear for a week now.  My right ear has regular tinnitis and pulsatile tinnitis.  I read somewhere that sudden tinnitis can be something like an aneursym or something.  Do you think thats what it is?  I also recently (2 days ago) developed pain behind and directly above my eyes - very painful!  I also have a lot of pressure in the front of my head by my eyes - like a band of pressure.  My questions are...
Do you think that anuerysms can develop that fast if my tests were clear 2 1/2 months ago?  What else could it be?  Should I seek ER tests soon?  I'm very worried and any help would be GREATLY appreciated!
Thank you and God bless!
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Avatar_n_tn
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
   The headache that you describe are unlikely to be due to anueryems or other ominous pathologies.  Anuerysms do not develop overnight, and most often are present for many years without causing and problems/headaches, then may rupture unexpectantly.  The good news is that you did not have anuerysms on your MRA and thus you should not be concerned.  MRA is not the best study for aneurysms, but is a good screening tool.  If there is any thing suspicious on the MRA a CT angiogram can be done that look at contrast dye filling in the cerebral vessels.  The 'Gold standard' is the convential angiogram, which is done when there is bleeding from an anuerysm(sub arrachnoid hemorrhage), to repair an anuerysm (through endovascular coiling, etc) or when other tests are unclear.  Your headaches sound like a primary headache syndrome and are most likely in the migraine spectrum.  I would recommend a MRV (magnetic resonance venogram) if you have not had one, since after pregnancy women are more prone to sinus venous thrombosis, which can cause headaches like you describe.   Topamax is a preventative medication that works after 3-4 weeks of use, so I would suggest giving it a full trial.  I think the BAER is a reasonable test to evaluate you complaint of tinnitus and ear fullness, and should also be accompanied with other tests of ear/vestibular testing, such as ENG.  In the case you described, I would recommend a trial on Indocin (a strong anti-inflammatory medication) and possilbly a medrol dose pack (steroid taper).  I would also caution against using to many over the counter pain relievers (tylenol, ibprofen, etc) because this can cuase rebound headaches.
I hope this has been helpful.
30 Comments
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Avatar_n_tn
Any help please?

Thanks!!!!
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Avatar_n_tn
I saw your posting regarding your symtoms (symptoms) my son is in the hospital with the same symtoms (symptoms) I would like to know what your  final diagnosis was?  The doctor does not know waht is goinging on with him and he is in alot of pain.!!
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Avatar_n_tn
I have no final diagnosis as yet.  Your son is in the hospital????  That sounds serious!  How scary for you.  I'm very sorry.  I called the neurologist yesterday and she seems to think it is migraines and chronic sinusitis.  I'm on antibiotics. I have an appt. with her next week so we'll see.  Has your son had an MRI or CT to rule out anything serious like aneurysm or brain tumor?  It could be pseudotumor cerebri which is something else she is considering for me.  Keep me posted and let me know how its going.  Good luck and hopefully we'll all get answers soon!
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Avatar_n_tn
What do you think?

Thanks!
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Avatar_n_tn
I really wouldn't freak out too much about an aneurysm with a recent clean MRI. People do get these long lasting headaches, especially with an aggravating factor like sinusitis. Did you try using nasal washes? The other day I had a lot of pain/pressure especially behind the eyes. Maybe the cold weather. Hopefully the Topamax and antibiotic will kick in. Are you taking painkillers/Triptans?
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Avatar_n_tn
Hi Mels22, I posted a comment to you here:
http://www.medhelp.org/forums/neuro/messages/34656.html
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Avatar_n_tn
Dear Friend,
  Please be advised that my response to you is not professional, is not medical advice, is educational, and that I am not a representative of MEDHELP.
  With that stated I see actually a possibly simple answer and that would be sinus induced tension headaches. MRI studies would have caught an anuer, et al, possible causes.
  I am sorry that I could not be more helpful, but I think that the answer is probably viral/sinus/tension head ache.

Good Luck!
JCmcc.
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Avatar_n_tn
What you are describing sounds exactly what I get when I get a really nasty sinus infection.  I have had headaches for up to 2-3 weeks with chronic sinus infections and the pressure is incredible!
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Avatar_f_tn
Hi.  Headaches and tinnitus in young women sometimes indicate a condition called "pseudotumor cerebri" which is elevated intracranial pressure.  This often occurs in women who are somewhat overweight (which I am not aware if you are or not).  It is a potentially dangerous condition which needs to be ruled out by a neurologist or an ophthalmologist who would check to make sure your pressure is ok -- that requires an eye exam and often a spinal tap.  If this condition goes on untreated, it can lead to vision problems or even blindness.  

Have you just had a baby?  Sometimes, women can have blood clots in their heads around the time they're pregnant and that can also create increased pressure.  

Having said that, chances are these are just bad migraines, maybe superimposed with some sinus problems that you might be having.  Talk to your internist about that, perhaps, he'd give you an antibiotic or a decongestant to try out.

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Avatar_n_tn
Hi and thanks for your advice.

I did have a baby but it was 9 months ago.  I am on prednazone (sp?) and amoxicilian for sinuses but the symptoms are unlike any other "sinus problems" I've ever had.  I am 5'7 about 145 lbs - I don't know if that is overweight or not.  I have an appt with my neuro next week so I guess she can check me.  I am very scared.  Does it sound like anything that is life threatening?  Should I go to ER or wait for my neuro appt?  The pain has been for about 15 days now.  The pain is mainly behind my right eye and above my right eye - also some in my right temple.  I also have right ear pain and tinnitus.  Does it sound like TMJ cause I do grind my teeth?  Thanks so much!!!!!
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Avatar_n_tn
I heard MRAs without contrast aren't THAT accurate...is this true???????  I'm soooo worried now.  Should I get tested again?  I just don't understand it...I still have the ear symptoms and localized head pain and dizziness but its nothing with my sinuses....then WHAT is it????  Can anyone help???  Please????

Do you think its an aneurysm?

THANKS!!!
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Avatar_n_tn
hi it cant hurt to ease your mind to go for another MRA with contrast.  I would go for 10 more MRIs if it would help me.  Wrote to you in another post.  like you I know my head isnt right either.  But thanks for your input on the BAER test I hope someone will give it to me.  Oddly enough two years ago i had a eeg and when the tech went from the right side to the left he said there was a difference on the right side, tech said hmpfff.  but told me probalby just nothing.  Asked doc and she told me well it doesnt mean anything.  Than hey why go for test to begin with.  Geeze I keep telling doc's something is wrong on the right side of head no one listens.  I still wonder and if anyone else can agree is it possibly if something is  small can it be over looked or even possibly scanned right over (to thick slices on MRI) and missed.  
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Avatar_n_tn
I just had an MRI and MRA done yesterday.  The MRI was ordered with contrast but only approved without.  The MRA was without contrast.  The MRI was for headaches I have been having, the MRA to check for aneurysms as there is a family history.

The Radiologist who was there (not giving the test--just there) told me that the MRI without contrast is the first step.  If anything is noticed on that they repeat with contrast (and that's when most insurance will cover it).  The MRA (even without contrast) will show aneurysms--that's specifically (for me) why the test was ordered.  

You could go for another MRA, whatever makes you feel more comfortable but at some point you HAVE to trust and believe your doctor.  I have had a zillion tests over the past year and even switched doctors twice.  My sister asked me once "are you only going to be happy if the find something?".  WOW.  I don't know, but I do know the doctors are doing the best the can with the information they have.  Beware of anxiety though, it will do a doozy on you if you let it.

I am heading to the Mayo Clinic in hopes to have more answers there--my husband says "what next--Cleveland, Seattle, Chicago?"  At some point you have to say enoughs enough.

I'll let you know if I ever get there:)))lol

Good luck to you and do what you need to do to be comfortable with your diagnosis.

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Avatar_n_tn
I JUST READ ABOUT CAROTID ARTERY DISSECTION AND IT SAYS THE SYMPTOMS ARE EYE PAIN, PULSATILE TINNITUS, NECK PAIN, ETC.

I.E.  A LOT OF THE SAME SYMPTOMS AS I HAVE.  IT ALSO SAYS YOU CAN GET THIS FROM CHIROPRACTIC CARE, EVEN SNEEZING.  DOES ANYONE KNOW ANYTHING ABOUT THIS?????

I AM VERY SCARED...DO YOU THINK I COULD HAVE THIS?

I HAVE THE PAIN BEHIND MY EYE, NECK PAIN, PULSATILE TINNITUS, EAR FULLNESS, HEAD PAIN, AND NOW I EVEN HAVE TINGLING/NUMBNESS IN MY HANDS AND FEET AT TIMES

DO YOU THINK I COULD HAVE HAD A STROKE????

PLEASE HELP!!!
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Avatar_n_tn
I believe that you should go to the ER as soon as possible if these symptoms are acute. No one here is prepared to diagnose you and your message is plainly asking for that.

It can take months to be ansered by a neurologist and even then he/she cannot diagnose you on here.

If the symptoms are not acute contact your PCP immediately and if you cannot get a same day/next day appointment see an ER resident.

I would act accordingly but do not panic.

Good Luck!
JCmcc.
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Avatar_n_tn
Actually, my neuro appt. is this Thurs. not in months.  So, I'm hoping to wait til then.  You actually think a 26 year old can have a stroke?  I'm trying not to panic, but that scares me.
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I agree with Jmcc as far as the last poster goes..go to the ED to get an evaluation, to make sure anything really serious is ruled in or out.

To the first poster with pressure type pain behind eyes and such with headaches, I agree that sinuses can do that to you. I am a cystic fibrosis pt. and have sinus issues, chronically....I have headaches like you describe quite often and lasts for some time too. Usually it is infection related) If the docs believe that your headaches are sinus related (Your MRI's and other tests were clean according to you) then maybe you should see an ENT doctor who can treat your chronic sinus issues (of course address this with your primary doc). I usually feel pretty good once the ENT gives me a course of antibiotics, sometimes I have to undergo scrapings of my sinuses if they are very full. I do wish you luck in finding out your cause for the headaches. Sunny
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Silly me...you are the same person, gahh! Sorry about that...but I still agree...Sunny
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Avatar_n_tn
You really think I should go to ER?  I had MRI/MRA/CT and all that already...what else will they do for me?  I take topomax (topamax) for headaches and have read this can cause tingling...is this true?

Thanks!

I honestly just want to make sure its not an anuerysm or that carotid artery dissection I read about...do you think it is?


My neck and head pain is intermittent and my tingling only happens at night.

I have a baby to tend to so it worries me to go to ER???

Any suggestions?

Thanks!
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Avatar_n_tn
I suggested the ER is your symptoms are acute and your message was written in capital lettering which means in linguistic typology. This is why.

So, again, in answer to your question: YES! If the symptoms are acute. If they wax and wan and have been around for awhile or before you had all of those tests and studies I would say "probably not" and to book an appointment with your family doctor.

Playing guessing games with your self will get you nowhere. In a sense, it can be torture. If your testing sequences were reported negative then this lessens the severity of your outcome in some respect. However, there is so much information that I do not have to be clear on my opinion.

You need to see a physician in person and if he/she says no and you are not comfortable; listen to your gut and see another. If this time this physician says "clear" then you will have to look elsewhere perhaps into psychosomatic problems, stress, et al.

Good Luck!
JCmcc.
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Avatar_n_tn
I hope you are feeling a little better today.  I just wanted to say that you need to pick a doctor or doctors you are going to trust and BELIEVE.  The more docs you see the chances that someone is going to find "something" increases.  It doesn't mean that something is wrong, it just could be that there is a some point a false positive.  I have had a number of echocardiograms, they all have been different.  The more tests you have by different docs they varied the results due to techs giving the tests to equipment.  Just be wary of that.

I don't think you have anything serious, but I am no where near a doctor.  I think you do, however, need to at least give anxiety a thought.  You can and will exacerbate your symptoms by reading online and self diagnosing.  No one here has the ability to see you or your charts and even if they did, they aren't clinically qualified to diagnose you.  You are going to get a lot of people telling you stress, anxiety but you are probably going to get a response of someone you says, YIKES go to the ER--I had that same thing.  

Actually a couple people, due to your appearant desperation suggested the ER and you questioned that.  I can really sympathize with what you are feeling.  I went to Centra care the other night because my chest hurt so bad and I was so short of breath.  They said my EKG was NORMAL but wanted to call an ambulance and send me to the ER because of my shortness of breath and chest pains.  Those are considered heart disease until proven otherwise.  I freaked out.  I said, I'll go but I'll drive and they said no.  I had to sign out of there against medical advice because of the liability on their part.  So my point is, what am I wanting and waiting to hear?  They said go and I said no.

Please stop reading and self diagnosing.  I have "had" all sorts of diagnosis since I started researching my chest pains online.  Scary, scary stuff.

Good luck to you and I wish you all the luck in the world.

tanns
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I am sorry I scared you..I didn't mean to..I thought that maybe your signs were happening at that moment, then of course that would warrant a trip to the ER. Another reason would be if you have severe pain that just won't go away with meds, interfering with eating or functioning, or if you have other new problems that just can't wait for a visit to the docs. You have been through alot of tests, the not knowing exactly what is causing all of this is sure taking its toll on you physically and mentally. I just hope that your doc sends you to the right specialists so that you finally can get relief. If he or she suspects other disorders, then more tests will be run.Hopefully there will be that one doctor who can put together the puzzle.

I went through alot of what you did tests, tests aand more tests...diagnosing me was a nightmare. I went to alot of different neurologists because of weakness in my legs, then I couldn't breathe when I exerted myself. I chalked it up to my ashtma. I couldn't have been farther from the truth..after a battery of lung and muscle tests, the docs found that I have a rare type of dystrophy with a paralyzed diaphragm. I now live on a vent. I am a rare case, a zebra within a large cluster of horses. Iwas called crazy, psycho somatic etc...prior to being diagnosed. Honestly, I went through 4 different neuros, 2 different pulmos. My lesson to you is to not give up, find your answers and don't let anyone call you nuts!!!

Oh an here is the icing on the cake...I was also diagnosed with cystic fibrosis not too long ago with the persistance of my primary doc. No doc thought of CF, I had alot of symptoms...rapid weight loss, growing wierd bacteria even for a vented person, developed diabetes and do have sinus issues. To make another long story short, I am treated at a CF center along with my other docs...team effort. Took years to finally get the right answers. I hope that this craziness won't happen to you, but like I said, follow your gut and fight hard if you need to.

Sunny
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Avatar_n_tn
Good luck at your appointment tomorrow.  I hope it goes well for you and you get the answers you need.  I'll be sending good thoughts your way.
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Thanks for being so thoughtful!  My appt was ok although my neuro does not think it is anything more than migraines.  But seriously, can you have eye pain for over 3 weeks every day and it be a migraine????  I am now wondering if I have something called Wegener's disease or a connective tissue disorder since I am told thats the only way an anuerysm can grow this fast.  She won't do another MRI and my reg MD doesn't want to either.  I am having a CT of sinuses tomorrow but that won't show an anuerysm.  I am VERY frustrated!  I am going to my sister-in-law's wedding next Thursday (we are flying to Arkansas) and I'm TERRIFIED that I have an aneurysm that will burst cause of the air pressure.  What do you think?  Yesterday my eye was droopy so I called the neuro...she looked and said it was either just a bad migraine or cluster headache...can they do that?  Do you know about Wegener's disease?  She said not an aneurysm but I have a bad feelling.  This eye pain is getting worse and my ear is still full and ringing as ever.  Oh and today I went to my GP cause I've had a cough and been feelign bad and I have bronchitus (bronchitis)!  I NEVER get well!  I'm sorry to babble on but I'm frustrated.  Bronchitus (bronchitis) would not cause my other symptoms.  What do you think I should do?  How is your search going?
THANKS!!!
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Avatar_n_tn
I really hope I don't come across the wrong way here, but I thought maybe I could offer some advice.  
Four years ago I was having these chest pains that were terrible, i would get the jaw paing and the pain down my left arm and everytime i would go into the ER, or my doctor, everything would be fine.  I even convinced my PCP to refer me to a cardiologist for an evaluation and again nothing was found.  
I know this isn't the case with you because something is wrong whether it be migrains or something else, but what i found was that my worrying was making everything worse. And I know it's hard to understand from where you are right now but worrying and stress can do so much.  My doctor started me on an anti anxiety medicine, and it changed my life. It seems you worry yourself into a spot that you can hardly function, and I know how bad that can be.  
Also, if you don't like what one doctor is saying, get a new PCP and start over.  Sometimes doctors and patients don't mesh.  

Again, I'm not at all saying that you are over exaggerating your symptoms, in fact, i'm sure it's a scary situation, it just seems you are over stressed, and some kind of anti anxiety therapy may help more than you know.
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Avatar_n_tn
Mels, I want you to understand first of all that I know what you're going through.  I too was having eye pain and a constant headache, and I scared myself pretty bad looking up every possible diagnoses on the internet.  After a while, I came to the conclusion that after 2 MRA, MR venogram (which the doctor suggested to you) and multiple MRI/Ct that I did not have an aneurysm.  However, there was something my first set of doctors didn't pick up on.  Alot of people have headaches and I even have an entire section of my website dedicated to it.  It may be in your best interest to get your films and take them to a University based Neurologist and request a formal review of them and a fresh perspective on your situation.  Private hospitals and doctors are next to worthless for anything other then basic problems, in my humble opinion.  Oh, in case you're wondering what I was diagnosed with it's explained on my site Robertmillerfoundation.org
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Avatar_n_tn
Ok somehow my thread got interrupted and I cannot see what others have said to me.  All I see are alchris' comments which are not helpful to me.  Anyway, I am still having the eye pain - it is extreme - just behind my right eye.  I went to the neuro, the ENT and the opthamologist all this week.  Nothing.  I had a CT of my sinuses and an MRI with contrast.  All it showed was chronic sinusitis once again.  Uggh.  I am on avelox now which doesn't really seem to be helping.  Before that (1 week and a half ago) when I went to ENT he gave me a steroid taper and amoxicillan.  Did not help - made my eye pain worse.  Now I am worried about the cavernous sinus thrombosis thing the doctor on here mentioned.  I checked and it sounds like what I have.  Questions though...would my MRI with contrast and CT of sinuses have shown that - I had them 2 days ago????  Also, I read somewhere that being on immunosuppresents (steroids) can cause a sinus thrombosis from chronic sinusitis.  Does anyone know if that is true?  I am VERY worried but the docs say I'm fine - just have to have polyps removed and deviated septum fixed.  Do you think I could have a sinus thrombosis?  If I did, how soon would it kill me?  I've had symptoms for a couple weeks now and my right eyelid is drooping.  Opthamologist said nerves look fine and pressure is good and MRI doesn't show a blood clot.  Should I press for the MRV the doc on here mentioned?  I'm very scared and am supposed to fly to Arkansas this weekend to be in a wedding.  Please advise - I would much appreciate it.
THANKS!!!
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Avatar_f_tn
Mels,
Skip the wedding.
You are going to be extremely uncomfortable on the plane with the changing air pressure, with all your sinus and the middle ear congestion.
You are going to have a lousy time while traveling and attending a reception, with all the pain and anxiety.
Face it, you are just too sick to go.

Carol






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Avatar_f_tn
Mels, I'd like to apologize.
I'm concerned about your situation, but it's not my place to tell you how to handle it.

Wishing you the best,
Carol
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