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hemangioma and headache; meningioma and bppv
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hemangioma and headache; meningioma and bppv

Firstly, fantastic web page and source of information.

I actually have two questions, I hope that's ok.  Recently, I was diagnosed with a cavernous hemangioma about 1.5 cm in the deep right frontal lobe. I also have been experiencing constant daily headache ranging from moderate to severe that seems to emanate from the same location as the lesion for the past two years.  (why I went to the doc's)   I was wondering if there was any correlation between the two. The headaches are debilitating - have been off work for six months.  I've been put on Neurontin @ 200mg 3x per day... not helping. I have a history of migraine, but this headache is completely different.. I get a migraine attack approx once every two weeks and take Zomig for it.

2nd Ques.  One month before me, my aunt was diagnosed with a benign meningioma 2cm in/on the occipital/parietal lobes.(left side) (We went for the 2 for 1 special on brain tumours) She also has BPPV. She finds that when lying down and turning onto her right side, the room spins... very unpleasant.  She wanted to know if there is any correlation between the two.  I don't believe she is on any medication for either condition. I've already advised her of the curative procedure I found on your website for BPPV.

Any info you could provide for either condition would be most appreciated!!!!
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Dear Ralph:

Sorry to hear about your cavernous angioma.  As you probably have previously read that a percentage of these are genetic.  They have a tendency to bleed and that is what induces their symptoms (unless they are in a bad position or large).  Usually, having a headache is how we initial discover them.  Your having a headache with these is the usual symptom.  Medication for these is usually patient specific.  They are not vascular and therefore many of the migraine medication do not work well.  You are on an extremely low dose of neurontin, you might check to see if going up on the dose might help.  We often push it to 600 - 900 mg tid and in some cases higher.  I would bet that your cavernous angioma bled and that is why your headache is worse.

You are correct about the meningoma.  Unless it is growing fast or in a really poor location (CP angle and causing deafness and diplopia) then surgery is the only real cure.  Radiation can be used, but usually they only come back worse.  Unfortunately, women are more effected than males.  Some meningomas are estrogen or progesterone sensitive.  So, if your aunt notices growth of her meningoma and she is on birth control pills, she should seek a good evaluation of other types of birth control.

I hope I helped.

Sincerely,

CCF Neuro MD
14 Comments
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sorry to interrupt, but i am deperate and at end of my rope with multi function neuro/organ problems...any ideas on what is the best time to be able to score to make your post...i keep trying and trying...but it always says full...
sorry
mary
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Mary, I too found it took a while.. I was able to post Sunday, around 10:00 am

Doctor:

thank you for confirming my suspicions that the headache is related to the c.h. or cav. angioma. To date every specialist I've seen tells me something different.  I am aware that these things are genetic and there is evidence of a bleed.  I'll see about upping the neurontin perhaps it will help.  

As for the meningioma, my aunt was wondering about the correlation of the BPPV episodes to the meningioma... ie. whether the increased intracranial pressure might have something to do with spurring a BPPV episode when turning onto her right side?

again, many thanks!

Regards
Ralph
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Avatar_n_tn
Dear Ralph:

I would find it improbable that her meningoma would cause BPPV.  The area of where the location of meningoma is not in the area that would cause this (usually CP angle).  However, we can never give a 100% prediction but I would doubt it.  What did her neurologist indicate?

Sincerely,

CCF Neuro MD
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Am not exactly sure what her Neuro said., will ask her.

Am going into hospital in next couple of days for intravenous dyhydroergotamine treatment for chronic headache.  This is supposed to "break the headache cycle" according to the neuro's here.  Will see in a few days.. with any luck, I'll get some relief...  The neuro's here don't think the headache and the c.a. are related.

Regards

Ralph
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Dear Ralph:

Let me know if the DHE works.  I really doubt it will, once the bleeding is resolved, the headache will also resolve.  Watch out for systemic blood pressure changes and also cardiac rhythm changes.

CCF Neuro MD
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34 yo female..I have had two unsuccessful transshphenoidal surgeries for a GH pituitary tumor diagnosed 4yrs ago. Gamma knife 98.  Finally controlling GH with new drug in clinical testing phase.  
Question is .two weeks ago I started with daily eye twitch off and on..no big deal.  In crease in headaches but not horrible. Last MRI read a few hemangiomas in the calvarium.  Could these cause a problem and be the result of the radiation?  I hate being paranoid about every little eye twitch but don't want to ignore if something is happening.
Thanks
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Avatar_n_tn
Well, am back... after the DHE.. a little worse for wear.. a less than pleasant experience to say the least...and, I guess this will come as no big surprise, I still have a headache...

Have been kept on the neurontin and put on amytriptylene and chlorpromazine (supposedly for pain).  I had upped the dosage of the neurontin, but that resulted in quite severe chest pain... so I stopped that quite quickly...

Will see how things go.. I, like you, have always suspected the c. haemangioma as the culprit.. although I'm told that the follow up CT and MRI show no new bleeds...That having been said, I was told that should the lesion "bleed into itself" it would not likely show on the CT..

Your truly

Still holdin' my head....
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Avatar_n_tn

Doctor;

You mentioned blood pressure changes.. (systemic).. I've not noticed any pressure changes.. except that mine has always been low.. and lately very low.. Not sure its indicative of anything ie. new bleed.. or more probably constant ooze.. 'just a wee dram at a time'

hmmmmm the saga continues.. meanwhile the meds that were prescribed don't do anything...big surprise there!

Cheers,
Ralph
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Avatar_n_tn
Dear Ralph:

Sorry that you have this condition.  Even more sorry that medications haven't worked, but time will and as the blood is reabsorbed, the pain will resolve.

CCF Neuro MD
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Thanks again!

At least there's hope... Compared to some of the things your other 'guests' to this site are dealing with, I find myself quite lucky!  The latest is the Ministry of Transportation who had pulled my driver's licence on the basis of a suspected seizure (as reported by the first neurologist I'd seen) now has concerns over my reportedly low blood pressure.  My new neuro (I seem to have several... don't know why.. that's the Canadian Health Care System...) had satisfied the Ministry that I didn't have any kind of seizure.. but reported my blood pressure 100/50 lying down to 120/80 sitting up.(normal).. Anyway, they want a log kept of my daily blood pressure.. before they reinstate my licence.. which means a 5 mile walk or bicycle ride to town every day... Guess the exercise will do me good!  And hey, my b/p will certainly be within range after that!!!

Welcome to the 3 ring circus that's passing for my life these days... Here's to better days!  Keep up the wonderful work!

P.s. Yep, I in fact, do have another neuro just for the headaches.
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Dear Ralph:

Laughter is one of nature's best medicines.  A man who lived this statement was named Norman Cousins who was at UCLA, in Los Angeles, California when I went to school there.  People who kept their sense of humor seem to always have better outcomes.  Hang-in there, enjoy the 5 mile walk.

Sincerely,

CCF Neuro MD
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Surry, but I can,t post any thing.  It is full every day...

  I have been diagnostic with AVM 8 years ago..I went to Mayo clinic to get the Gama Knife and the doctors did,t want to give me this tratment because I had a little blood on my head.  Rigth now, in my last MRI I can see perfectly the malformation, cavernous, left frontal lobe, 1.6 cm very deep.  Some doctor told me that is URGENT to make Embolization.  I am so afraid, I want the Gama Knife but they say this can work till 3 years after do it, and they don,t want to let me as I am rigth now.  My question is.  Is this case a very Urgent prosess to do it  ???..
  And for RALPH, there a mexican medication for your migraines.  I have tried a lot of medication and this mexican pill raly works.
If you want to know more about mail me to ***@****  I am not a doctor, so you have to ask your doctor before take this pill.  I am just a person that have been with your same simtopms for 8 yeras and I know that you feel.   HAPPY  NEW YEAR.
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Avatar_n_tn
Dear Carmen:

Cavernous angioma can bleed, but whether an urgent surgery is needed is another story.  Many people go throughout life not knowing they have one, and others have many problems related to bleeding and rebleeding.  I depends on where the angioma is located in the brain.  If in an eloquent area (one with alot of needed funtion) then surgery may be impossible as it would cause more damage than the bleed.  But if it is in the frontal lobe, then there is less eloquent function here and surgery is more likely not to cause alot of damage.  If possible, I would see if they could do the AVM by radiological intervention (cath ablation) first before okaying open craniotomy.

Sincerely,

CCF Neuro MD
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