Is it a migraine or possibly an aneurysm. Urgent

I really need to get some feedback here regarding pains I am having

I had another post some months back so I wont get into details of the entire history of my head pains.

For the last two / three weeks I have been having a horrible sharp and pressure Luke pain in one particular spot on the top of my head.

I felt the area and noticed a rather large dent in my skull in the exact spot the pain comes from. I decided to massage the area and suddenly my entire body was shocked with an awesome amount of pain from the area

I made my way to the er hospital and was rushed to be seen. All the basic check ups such as bp / heart rate and basic neurological tests were done. The er doctor was not satisfied and had a ct scan done on my Brian. All results were good

Now a few days later the pain still is there and wont go away. My right eye has sharp feelings in it and is slightly droopy. My pupil on my right eye also at times expands more then my left

What the heck can this be. I have had the following tests done in the last 7 months

EKG
Cat scan of brain and neck
Basic blood work
Cat scan of brain with dye contrast pumped in after regular ct scan
MRI of brain and neck and neurologists check up
Cat scan of brain
Intense blood work and metal testing

I keep thinking I have a brain aneurysm in the spot that is dented and hurts. And at times feel as if there is no point even caring about life

Thoughts and suggestion. Would my imaging tests rules out a anerysum


Thank you

Hi Alex,

Wow.... That is REALLY perplexing. So you have had 2 clean CT's and 1 normal MRI? Hmmm.... sounds like this is going to take some medical detective work to get to the bottom of this one.

If I were you I would go to the hospital again. And if I were in your shoes and I had several hospitals nearby, I would try a new one (rule our radiologist error. With three tests performed though, this is honestly highly unlikely). I would guess, statistically, the most likely cause is some type of migraine. Try not to worry too much unless it is proven to be something more concerning.

My skull is pretty lumpy, bumpy and touching one of my particular bumps will trigger a migraine. For a few years now (well... I've noticed for a few years) one of my pupils dialates 30-50% more than the other. My migraine specialist believes it is part of my classical migraine.

I would recommend making an appt. with a headache specialist. If you decide to go to the ER, ask the doctors what they would recommend as a next step.


Best of luck!

PS by MRI head and neck do you mean MRI/MRA? MRA and or doppler would probably be goods test to ask about. I should be quite, lol... the ER will know best.

Post Edited (EvilFluorescents) : 3/10/2011 12:24:01 PM (GMT-7)

Hi Alexkid,

Sorry to hear you are having a rough time. Is this sharp pain there all the time or does it come in short bursts? How long does it last? Do you have any facial sweating or watery eye?

I am not being funny as I have a purpose in this, but please try and answer these questions as precisely as you can - thank you!

Please be assured that if it was something like an aneurysm it would show up on the scans. So your clear scans and bloodwork are very good news.

I would strongly sugggest that you find yourself a Neurologist who specialises in Headache as they will know far more about any headache than the usual Neuros.

Please let me know what happens, take care

Ann

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Co-Moderator of the Migraine/Headache Forum

DX: Hemicrania Continua, Chronic Migraine, IBS, Allergic Rhinitis and Heart Murmur

Meds: Imigran Injections, High Flow Oxygen, Mebeverine, Lansoprazole, Nasonex and Clarityn

Annuk

The sharp pain is in one spot which is a slight dent in my head. The pain is not as noticeable if I am relaxing or lying down. However if any type of physical strength is needed eg picking up a box or doing some work it comes on

The pain is a sharp pain in the exact spot it will last for 3-10 seconds once it comes I become unable to focus This may come as bursts meaning 2 or 3 one right after eachother. however usually one at a time. It is not constant it will stop for 10 30 minutes but generally come back.

My eye only the right is affected. It has blurriness and a sharp pressure like feeling in it. The drooping of the eye may not be an issue as I look at pictures from years ago before these pains and it seems I have always had a droop

The eye is generally more dry then moist but at times can become wet when a really bad pain comes redness is generally not accompanied with the head pains but pressure is

4 months ago I had an exam with a optometrists who checked me in great detail as he knew my situation. I also had 8 retinal scans which showed no tumors or detached retina. Or other vessel issues

The only other symptom is constant dizziness and imbalance. This is funny because while the migraine is killing my head I am not dizzy. However once the migraine goes away the dizziness and imbalance begins

Please help me

Ps. Evil. My last brain ct scan was 5 days ago I don't know if I can afford or be allowed to have any more. My main concern is am I possibly living with something that is deadly. Eg aneurysm / brain damage / tumors etc

This has been a horrid time of my life 7 months of hell. To make matters worse after 12 years of trying to have a child finallly we have been blessed yet I can't even enjoy or support my wife due to this horrible pain

Ps I have spent nearly 15k on tests and scans out of my pocket with no resolve. If anyone can point me in the right direction I will be ever grateful

Thank you

Ps no facial sweating present more like a dry skin feeling as if my skin is tightning up

I just got back more intense blood work from my doctor all was good with the blood work

Hi Alexkid,

Thank you for your response, this has helped me rule out a few things. I doubt that this is anything too serious, and again would strongly urge you to make it a priority to see a Neurologist who is a Headache Specialist.

You may have to travel to find one, but it will be so well worth it!!! There are some rare headaches that are perfectly treatable that only a Headache Specialist can diagnose. Please try not to worry and see that Headache Specialist and let me know how you get on.

take care

Ann

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Co-Moderator of the Migraine/Headache Forum

DX: Hemicrania Continua, Chronic Migraine, IBS, Allergic Rhinitis and Heart Murmur

Meds: Imigran Injections, High Flow Oxygen, Mebeverine, Lansoprazole, Nasonex and Clarityn

Hi Alex,

I'm sorry you're having to go through this. I know it is not a fun experience (in the least).

Ann is right. If you have had similar attacks and 3 scans (ct's and mri's) recently, all showing no abnormalities, the risk of organic causes (aneurism, tumor, etc.) are very very to slim to none. Now I have to stress that I'm not a medical professional, so I would recommend calling your GP and asking for his/her opinion. I am confident however that once you make him/her aware of all the facts s/he will give you a referral to a neurologist.

I would recommend making an appointment with a headache specialist. I think treating this like a migraine will yield the best results.

In the future, if the migraine meds don't work (which I really think they will), because of the way you describe the pain as quickly shooting throughout the body and the "bone dip", treating this like a neuralgia would be an interesting alternative.... Just a thought to file away.

Call your GP, Make an appointment with a headache specialist and I wish you the best of luck.

Thank you for the kind words and help regarding this horrific matter I will add some more info here and hopefully get some more feedback

I have seen a well known neurologists only 2 months ago. He is well known in the field and specializes in migraines. My visit was brief but he examined me well. He booked me for the MRI I had mentioned. After all was said and done the MRI was good only issue was a small bone growth on my neck which posed no threat or issues. He diagnosed me with vascular migraines and proscribed this medication

Apo-nortriptyline 1 capsule before bed 2 after two weeks

I have not taken the medication as I am worried it will make me depressed and very dizzy as I have read some of the side effects and it scares me. If you know more about this medication Please let me know

I wanted to point one other oddity with this pain if I move my neck or body in a certain way it triggers the shock wave pain from the dent which literally leaves me in shock. It's scary but I get through it

Any info would help and you both have been wonderful helping me out

Thank you

Hi Alex,

I recently left a thread in a different HW forum about the med:

http://www.healingwell.com/community/default.aspx?f=19&m=2049367

hopefully it answers your questions and addresses your concerns.


It is an old anti-depressant, so it is much, much more likely to lessen your depression then increase it. Like I said in the thread, I've been on it ( and related meds in the same class) and so if you have any other questions I would be happy to answer them.

How much are you starting on (how many mgs)?

Strong, sudden pain can be pretty nasty and disorienting. I'm sorry you're having these issues. I would recommend starting the meds your doctors prescribed. If you're still having the same problems next time you meet with him, it may be helpful to describe the pain in detail just like you did above.

Best of luck!

Wow, I was doing great today until approx 2 pm

I was in my lab doing some work and as I slightly turned

BANG / BANG

Two horrific jolts of pain came in the dent area of my head which I mentioned before I just stood there in shock made a prayer. I felt dizzy and completely out of it. Did a few checks (counting regular / backwords) read a few paragraphs and so on.

The first thing that comes on my mind is "am I dying" here it comes. I tried to stay calm and collective and took two tylenol gel caps 500mg. It started to kick in after approx an hour and worked for about 4 hours (its slowly coming back now) . My right eye had good pressure in it and pain and yes was watering this time (not sure if this means anything).

Evil: the medication is 10mg at start and then 10mgx2 after two weeks (i have yet to try it) but think tomorrow will be my first day. Few questions regarding the medicine for you

- Am i able to drive and get to places normal as I first take it ?
- Does it really make you depressed badly in the initial start up of the med
- What should I look out for (dangerous signs with the meds) while on it

I am contemplating going into Mount Sinai hospital here in Toronto for a full MRA (this is the only brain scan I have not done). Problem is its going to cost me 2800 for the test and 1000 for the er service.

Is it normal to have a striking / stabbing migraine in the exact same spot for nearly 3 weeks. Its really absolutely destroying me.

Why do you have an indentation on your head? I have several but they are there because I've had brain surgery. I have sharp shooting pain also, mine is on the right side of my head. I have had a nonstop migraine for weeks now :(. I was suppose to get a call from my neurologist today about getting botox injections, but didn't get the call. If my insurance doesn't cover it, then I can't afford the $700.00 injections. The neurologist said I'd probably need them every three months! that can get Very expensive! I hope you find the answers to your pain, I know how hard it can be.

Blessings,
Mercyme

Hi Alex,

Everyone reacts differently to meds. Especially initially when you are adjusting.

Personally, I was able to drive my first day on the med (no big deal at all). Like I mentioned in the post it made me a little tired, but not debilitatingly so.

I'll be honest with you, the med impacted my memory (a little bit). This made me a bit depressed. As I got used to the med and my memory returned, I came out of the depression. Eating eggs also helps (refer to the previous link). Again, everyone reacts differently to meds. This won't necessarily happen to you.

Because it is an old Anti-depressant, as I got used to the med I found I became more relaxed/less anxious than I was pre-medicine.

Have you described the pain to your headache-neuro, they way that you have described it to us here in detail? It really sounds like a pinched/irritated/constricted nerve. The good news is they use nortriptyline for that also.

Best of luck!

Update:

Well the migraine / pains in the head have calmed down about 40 / 50 percent however now I have constant
Dizziness / horrible pressure in my head / sharp pains in my right eye (pupil dilation is still slightly different in the right eye). Very hard to focus at times as I feel I may just simply pass out. No vomiting / No seizures etc.

I also find myself horrible uncomfortable if I need to be in public, meaning the symptoms come on very quickly (blurred vision / dizziness etc). I don't know if this anxiety or warning signs of a migraine.

I visited my GP doctor again, and we had a discussion. I again brought up the possibility of tumors / aneurysm etc and he stated "we are barking up the wrong tree" He does not think this is the case and that he does not want me having any more imaging scans done as I am radiating myself horribly. He rejected any MRA / MRI scan for a second time (my last MRI of my brain and neck was 2 months and 8 days ago).

He prescribed me a new prescription which I am very worried to take

Topamax Sprinkles (25mg)

Now my questions is which one is safer and a better medication

-my original prescription from my Neurologist whom I have not seen in two months (apo-nortriptiline)
-or the new medication topamax sprinkles

Also because my eye pain in my right eye is so severe do you think its worth paying to see an opthomologist (this will cost me approx 500 dollars). I did see an Optometrist approx 4 months ago with a slew of tests done.

ps

is it normal for people with various head pains to become strongly depressed ? I have had the pain and problems for 7 + months now and I cannot remember the last time I smiled or had a good day ? Just wondering if I am alone here or going crazy

get an mra

OK I've read through this thread and having just come home from the hospital from having a brain aneurysm "fixed" I have a few educated comments to make.

First off.. all these cat scans were for naught.. sorry to say.. they are pretty good for showing a "bleed" or a rupture but not so good with DX
first I had a MRI to rule out a mass.. this was because I have terrible Migraine headaches since I was 9yrs old. I've also had 2 concussions..
the MRI showed something that could be an aneurysm or just tortuous vessels but in the words of my neurologist "Don't worry it usually is nothing"
Had an MRA that clearly showed that I indeed had an aneurysm.. right between my eyes!! That was not where I had pain. My pain started behind my right eye.

OK so this is the part that is more interesting.... It wasn't until the brain angiogram that they saw exactly what it really looked like and what the arteries were like next to it... and it wasn't until they were fixing it that they realized how much more complicated the entire procedure was.. it was touch and go for a while. What was supposed to be 2 hour became over 4 hours.. my poor boyfriend was so scared. I was in the ICU for 2 days and then another 2 days in the step down neuro wing.

Now I will back up to the headache that drove me to this neurologist.. I was already in the hospital for something else.. another crappy thing that was probably related to all the auto-immune diseases I have been "blessed" with in the last year and a half... I woke up with the worst headache of my life.. and this is clearly the main symptom of most aneurysms. Being in the "wrong" wing of the hospital I was left to suffer until my boyfriend arrived with my fiorinals... (I can't take most of the usual Migraine drugs) I took one and immediately projectile vomited it across the room.. I hadn't actually thrown up when I had a migraine since I was a teenager. No one came to look at my pupils and test me neurologically.... I sleep off this horror headache which lasted all day.. My neck was also killing me.. another clear clue.. Luckily I lived to go home the next day.. and vowed to see a headache dr finally.. until now my main drs have always prescribed whatever I needed.

OK so my head is worth a small fortune today.. platinum coils and a stent in the noggin.. I just got home a few days ago.. saw 3 different brain drs till I settled on the one I used. He is a "rock star' neurointerventionist at a prestigious hospital here in NYC. I am currently on gabapentin 600 to 900 a day and fiorinals when needed because I have a headache that should go away in a week or 2.. I should point out that ALL these drs are convinced I experienced a small "bleed" when I was at the other hospital months before.. I am very lucky that it didn't rupture... the stats are awful on ruptures.. I am also VERY lucky.

you still haven't had a MRA or a brain angiogram.. does your neck hurt? does the pain change sometimes from one eye to the other? Just wondering because that is what happened to me and in all the years I've had migraines that had never happened before

oh and yea.. I've always been depressed so I can't even tell you what normal is. Having these headaches since I was 9 you have a different prospective on life and grow up a lot quicker than the kids around you.

NY VEGGIE

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Brain Aneurysn FIXED, Crohn's, Migraines, Fibromyalgia, Hypothyroid, Polychondritis, Pericarditis, Depression
Lacto-Vegetarian Low-Residue Diet,
Solgar V-75, Gentle Iron, Calcium, Vit D, Flaxseed Oil, B2, Biotin, B12 shot, Turmeric
Pentasa, Metaprolol, Gabapentin, Synthroid, Protonex, Plavix, ASPIRIN, Flexerol, Zocor, Xanax, Fiorinal
Was on Entocort, INH, Prednisone, Prednisolone, Cipro, Flagyl