"occasional headaches after Hydrocephalus shunt insertion

[GlPz]

Vestibular Schwannoma (acoustic neuroma) of 2.5 cm was diagnosed by MRI following  gradual loss of hearing in the right ear of a lady relative age 60. A radio surgery was performed on October 07. On June 08 imbalance symptoms progressed into lower-limbs fatigue (“dragging of legs while walking”) led to another MRI,
That revealed hydrocephalus. A VP shunt was inserted on the end of July 08. Recovery seemed OK. CT a day after the surgery and 10 days later were OK. Few weeks after the shunt insertion stomach pains, short, very strong, not in a specific place were experienced. Stomach X-ray didn’t reveal anything. Carbo Animalis pills and Colotal (MEBEVERINE HYDROCHLORIDE) relieved the pains; however didn’t stop them, though the frequency was lessen. In the last couple of weeks few occasions of sharp headaches occurred; only in that side of the head where the shunt was inserted. Not on specific time of the day. Last night she awakened after some hours with sharp pain that was over after 30min following taking Optalgin (DIPYRONE 500mg) and walking around the bedroom, then fell asleep again. There are no signs of infection (temperature is normal). Balance is fine. Walking is OK though limited (half a mile) and a bit tiring (considering the fact that no physical exercise was done for almost two months). The lady returned partially to household duties (cooking and cleaning) , nevertheless “taking it easy” .Garden working that demands continuous lowering of the head (like removing weeds) is still impossible. Usual “job” (sitting in front of a computer, creating new text ) is also possible, though not in the usual pace.
I am worried from over/under drainage that will lead to another surgery which terrifies me. The head nurse of the Neurosurgery department where the surgery was performed (the Neurosurgeon that operated is abroad. A checkup is due on the end of September 08)  calmed me by saying that as the headaches are  occasional and not permanent it is probably due to the short time passed after the surgery and this is an acclimatization period that can take few months.
Any ideas? Suggestion? Comfort?
Thanks










This discussion is related to headaches/vomiting in child with shunt when CT scans are normal.

[GlPz]

CT was conducted. The analysis by the expert (NOT a neurosurgeon!!!) is that everything is OK. The size of the Ventricles is normal and no signs for under/over drainage.
I'm still puzzled with the systematic "nightly"/ early morning wakes-up with sharp headaches only in the side where the shunt is inserted, that Optalgin, upright position and walking around solve … for the next 24h

[GlPz]

Well, we still hope that the fact that a pill of optalgin and getting up from horizontal lying relieve the pain for 24h is a good sign

[DrNoopurMD]

Hi,

Yes if the symptoms are becoming more frequent it is best to get a CT scan done.
Let us know if you need further help.

Take care!

[GlPz]

Well, since I wrote the 1st inquiry, the occasional is becoming systematic at least on the last three mornings.
I think we better take the risk and arrive to the neurosurgeon with an updated CT.

[DrNoopurMD]

Hi,

Since she does not have any other symptom apart from occasional headaches it is best to avoid a CT scan as you have rightly mentioned it will only increase the radiation exposure.
Please wait till she gets evaluated by the neurosurgeon if need be CT scan can be done at that time.

Do keep us posted!

[GlPz]

Thank you for the response.
So far there is no nausea, no vomiting, no negative personality changes or mental deterioration.
Wrt the last two - the opposite is noticed at least at present. The best symptom in my view, that she returned to her creative work which demands sitting in front of a computer and writing new original text.
Would you recommend repeating a CT, so she has results before the meeting with the neurosurgeon next week, and there is something to analyze and diagnose, and compare to the last CT that was taken on August 7 and was OK. Or maybe she should avoid it as it will be the 3rd CT in two months and considering the high radiation she received on October 07 in the radio-surgery of her acoustic neuroma

[DrNoopurMD]

Hi,

How are you?
Yes it is quite possible that the headache which occurs occasionally is due to the fact that very little time has passed since surgery.
However it is important to keep in mind that symptom like headache, malaise, mental deterioration, personality changes, raised BP and neck pain are signs of shunt malfunction.
Please watch her closely and notify the neurosurgeon if any new symptoms develop or if the headache gets worse.
Take care!