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Headaches, black outs, dizzy spells. MRI showed microadenoma on pituitary gland. lumbar puncture unsuccessful. Treatment for headaches ?

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I am a 26 year old female. I have had headaches my whole life. About two years ago I started blacking out so i had an MRI. The MRI showed that I have a microadenoma on my pituitary gland. My neurologist told me that these tumors happen in 20% of the population and this was not the cause of my blackouts and headaches. We also found that I have papaledema in both of my eyes and when they tried a lumbar puncture there was no relief. My headaches have turned into a mirgaine that never goes away, most days it is difficult to open my eyes and I have dizzy spells all the time some to the point of blackout. What is wrong with me?
Posted Wed, 2 May 2012 in Brain and Spine
Answered by Dr. Shiva Kumar R 11 hours later
Hello and Thanks for the query

Regarding the headaches and black outs with increased pressures in the eyes (papilledema), looks like you are suffering from a condition called Benign intracranial hypertension (BIH). The headache's in this condition look like migraine and sometimes migraine and BIH can co-exist.

BIH is common in people suffering from thyroid, PCOD(Polycystic ovarian disease), exposure to OCP(Oral contraceptive pills) and in people with history of recent weight gain. If BIH is not treated ,adequately high pressures in the eyes can damage the nerves.

Pituitary microadenoma is a normal finding in many and it is not responsible for your headaches and probably is an incidental finding on the MRI. Visual assessment for acuity and fields has to be done regularly to look for early signs of involvement of the optic nerves.

If the pressures don't respond to medical treatment, surgical options like optic nerve fenestration or lumbar theco-peritoneal shunt may be required.

This is a very difficult time for you I am sure. The bottom line is that I think you need to talk to your GP and if possible to a Neurologist for the possibility of BIH and migraine.

Thanks again for the query. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.

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