Pressurized feeling in head vs. headache

[Jules77733]

I saw a neurologist regarding my 13mm pineal cyst and the fact that every so often, I have headaches that are excruciating at times, accompanied with nausea and dizziness, as well as intracranial pressure. When I don't have a particularly bad headache, I generally have "heavy headed" feeling every day, along with a feeling of pressure build-up in the upper half of my cranium, if this makes any sense. Usually a dull ache, of varying pain/intensity is present, but not as frequently as the pressurized feeling.

My neurologist really tuned into the fact that I get headaches and said I have migraines, prescribing me 25mg Topomax daily. I'm wondering how I can better differentiate to him at my next visit my feelings of pressure in my head, versus actual pain? I feel a lot more pressure, but this is sometimes accompanied with a dull ache or a really bad ache. Is this consistent with migraines? I was also a little surprised he wouldn't look at my MRI images (this is the first time I saw him as a patient). He said that radiologists are the experts at reading MRIs, so he trusted the radiologist's report...even though I wanted him to look at something my GP was concerned about, too, near my superior sagittal sinus. I also wanted him to look at the pineal cyst, too, just to see if he picked up on any details the radiologist may have missed. Just wondering--is this standard procedure, or if I'm concerned should I almost insist that he take a look at the images for me? I didn't want to overstep any boundaries, especially given that we were meeting for the first time.

Thanks for your help!

[Jules77733]

Thanks for your prompt response.

I'm doing alright...still frustrated because I'm no closer to discovering why I'm sick and yet I'm too young to be stuck in a rut this way. Nobody seems to want to consider all of my symptoms as a whole, and since none of the specialists talk to one another, I have little hope that they'll figure out what's going on anytime soon.

My above question was posted because I was just wondering how to explain the difference between a "headache" and "pressure" in the head (not pain). My neurologist didn't seem to understand that I experience pressure and a heavy-headed feeling more often than I experience a terrible, splitting headache. Yet he still diagnosed me as having migraines, and gave me more medication to take. I'd rather not get more medication...I'd rather figure out what I really have and be treated (if medication is the only way to do this, so be it, but I'm not so sure this is the case).

[DrNoopurMD]

Hi,

How are you?
Pineal cysts are usually asymptomatic although sometimes they can cause headaches, visual disturbances and hydrocephalus.
They need to be monitored closely by doctors.
The heavy headed feeling and pressure sensations can also be due to sinusitis. I would suggest to you to discuss this along with the MRI report with your neurologist, if you are not satisfied, then please do not hesitate to seek second opinion.