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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Headache, Vomiting And Light Sensitivity Despite A Normal CAT Scan Report

My daughter has been having headaches for a solid month along with nausea, vomiting, light sensitivity, loss of appetite. We have ruled out the following thru different testing, vision changes, strep, limes disease, mono, cat scan came back fine and blood work looked normal. What should I do I am so stumped.
Tue, 23 Apr 2019
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Neurologist 's  Response
Hi,

She has all the salient features for suffering migraine headaches. The only question (which seems to have answered at this point) is whether or not the headaches are being caused by something or if they may simply be primary (i.e. not due to anything specific other than her predilection for such headaches).

If the CT scan is negative for intracranial mass lesions I would order an MRI of the brain and look for any obstruction to the flow of CSF such as would be seen in a Chiari malformation which is more common in the population than is diagnosed.

There could be other things in the neck triggering migraine-like headaches that CT scan may not pick up such as nerve roots being pinched or even the spinal cord itself being impinged upon so that an MRI of the cervical spine may also be worthwhile looking at if she complains at all of the neck, shoulder, or arm pains that travel.

If all workup is unrevealing then, I would simply treat her with antimigraine medications and try and break these before they become chronic.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Dariush Saghafi, Neurologist
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Suggest Treatment For Headache, Vomiting And Light Sensitivity Despite A Normal CAT Scan Report

Hi, She has all the salient features for suffering migraine headaches. The only question (which seems to have answered at this point) is whether or not the headaches are being caused by something or if they may simply be primary (i.e. not due to anything specific other than her predilection for such headaches). If the CT scan is negative for intracranial mass lesions I would order an MRI of the brain and look for any obstruction to the flow of CSF such as would be seen in a Chiari malformation which is more common in the population than is diagnosed. There could be other things in the neck triggering migraine-like headaches that CT scan may not pick up such as nerve roots being pinched or even the spinal cord itself being impinged upon so that an MRI of the cervical spine may also be worthwhile looking at if she complains at all of the neck, shoulder, or arm pains that travel. If all workup is unrevealing then, I would simply treat her with antimigraine medications and try and break these before they become chronic. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist