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Cavernous angioma and the relation to migraine headaches

      Re: Cavernous angioma and the relation to migraine headaches

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Posted by CCF Neurosurgery MD on October 29, 1997 at 14:52:41:

In Reply to: Cavernous angioma and the relation to migraine headaches posted by Linda Novick on October 28, 1997 at 21:20:30:

: My daughter was found to have a right fromtal lobe cavernous angima 4 years ago during a routine work-up for migraine headaches. She is now 20, still gets migraines and would welcome the idea of medication. She has migraines with auras,nausea and most recently numbness of the fingers. She has also spoken of a "feeling of her body being out of control"
  The neorologist is not concerned about the angioma...he said that there is no connection. My question: Is there a relation? If cavernous angiomas are known to get larger, bleed and involute...could their be a relation?
  She is due to have a repeat MRI and an EKG in November. The Dr. is talking re: medications...Inderal or Elavil...Please respond... I am an RN and am in the process of accumulating literature. Thank you...
Dear Linda,
You are likely dealing with two separate issues with your daughter.  Cavernous
angiomas are benign masses of vascular tissue without intervening brain tissue.
They may occur anywhere in the brain.  Cavernous angiomas may present with
seizures or deficits from mass effect in a particular area of the brain.  
Over time, they may bleed and grow larger.  Definitive therapy is complete
surgical resection, though many may be observed clinically.  The key factors
involve the size and location of the angioma.
Migraines are typically unilateral headaches most often in the female population.
They may be preceded by a visual aura followed by a severe headache, nausea
and vomiting.  Afterwards patients usually wish to rest in a quiet, dark room.
Migraines are treated acutely with medications that help constrict the blood
vessels in the head.  Other medications are used for prevention and work via
different mechanisms.  
It sounds like your daughter is having problems primarily from migraines.
The symptoms you describe are typical of migraines.  The cavernous angioma
was likely an incidental finding when they did the MRI.  A cavernous angioma
in the right frontal lobe may be removed without much problem, but your
surgeon may choose to observe the angioma for the time being.  This decision
should be made taking in the overall situation and considering you and your
daughter's wishes.
Good luck.

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