hemangioma

I was diagnosed with a hemangioma on left frontal lobe in 1985 by CT angiogram. It has not given me any problems until the past few months. I have had chronic, often debilitating headaches, blurred visioin, occasional loss of balance. The neurologist who diagnosed this stated it would eventually give me problmes and think that time has come. I can no longer stand these headaches. I take enough over the counter meds to acutally have right upper quadrant pain near location of liver. The area where the lesion was located is very tender to touch. Recommendations

[Christopher R Newey, DO]

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 a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Hemangiomas are structural lesions that can cause symptoms. However, migraines and other forms of headachres are also very common. Without further information, it is difficult to say if the headache is a primary headache (such as migraine, tensions, etc) or secondary to the hemangioma.

One thing you do mention is the use of over the counter medications. One of the most common causes of headaches in people with chronic headaches is called medication rebound or medication overuse headache: medications as simple as tylenol or advil if used too much can cause rebound headaches that are even worse then the headaches for which the medications were started for. This is very common and is most likely to occur with use of any medication for your headache more than a few times a week. It can occur with all the commonly used headache medications such as ibuprofen, triptans (such as imitrex), fioricet, and commonly with any type of narcotic such as tylenol #3, dilaudid, percocet, etc. The treatment is difficult, but basically involves weaning off the offending agent and replacing it with another that is later weaned off, combined with a more long-term solution. This should be done under strict guidance by a specialist, preferably a headache specialist, or else the headache will not improve and withdrawal side effects can occur.

It is always better to have a medical evaluation and management prior to surgical procedure.

I would recommend that you be evaluated by a neurologist who specializes in headache.

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