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What causes constant headache and nausea? - Online Doctor Chats

Date : 12-Apr-2014
User rating for this question
Very Good Posted in: Headache and Migraines
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2585 Questions
User:MRI results conclusion: Asymmetrical moderate narrowing of mid left transverse sinus appears longstanding. Clinical relevance of this is unclear. Clinical correlation for Idiopathic Intracranial Hypertension symptomatology may be helpful. Moderate mucosal thickening seen in partly visualised maxillary sinus, mild on left. Polypoid configuration on the right suggests possible mucous retention cyst or polyp.
Neurologist told me that she could help me no further and I would benefit more from seeing a chronic pain specialist? I have constant headaches and nausea but neurologist didn't believe the MRI conclusion to be a problem or reason behind this.
Doctor:Sorry to hear about your headaches
Doctor:A going through your MRI findings now
User:Okay :)
Doctor:Ok. So, it looks to me like your trying to deal with these headaches and nausea
User:Yes I am.
Doctor:And the MRI has made things more confusing rather than less
User:Yes, my neurologist doesn't think that the conclusion would be giving me headaches
Doctor:May I ask how long you have had these headaches? When did they start?
User:2009/2010, I will have them for 7 weeks at a time, have sometimes a couple of days relief
Doctor:Ok. HAve you noticed anything that triggers these headaches? A season, stress, anything?
User:No, nothing. I wake up with them and they are at their worst then
Doctor:Ok. Does standing up or sitting up help?
User:It can yes, sometimes when I am standing for awhile I forget I have it, until I lie down again, but not always
Doctor:Ok, Thanks, that helped
Doctor:Now, are you a coffee drinker? Or better yet, can you tell me if caffeine intake of any sort will worsen or alleviate the headaches
User:No, I stopped caffeine a couple of years ago, including coffee. I don't know why my neurologist said she cannot help me and my MRI results meant nothing
Doctor:From what I can glean from what you have told me. I believe the Radiologist may have brought up a very important issue. I think you may have Idiopathic Intracranial Hypertension
Doctor:It's pretty rare. I have only seen maybe 4 cases in my 10 years of residency and practice.
Doctor:And it CANNOT be diagnosed on MRI. It requires a functional assessment of the patients ICP (Intracranial Pressure)
User:ooh okay, my neurologist stopped her services to me so I cannot go back because she told me she had exhausted her expertise.
Doctor:So in a way. I agree with your Neurologist. I don't think the MRI is going to help you here.
Doctor:And I don't think the Neurologist can help you here either
Doctor:This isn't their bailiwick
Doctor:I think you need to take this MRI result and your symptoms and find a good neurosurgeon
User:She suggested I go and see a headache specialist or just a pain management specialist because its a chronic pain issue, will either them help or just a neurosurgeon?
Doctor:They are the people who deal with ICP issues and they are the ones who know how to test for it
Doctor:Well... i'm not a big fan of going to pain specialists until EVERY other possibility and avenue for treatment has been explored
Doctor:But that being said... You're the one in pain.. so it really depends on how bad this is getting in the way of you living a normal life
User:Okay, the headache specialist she suggested is also a neurologist. It is impossible to see a neurosurgeon in australia without a referral so I will just have to keep at the doctors to do something more
Doctor:Hmmm. Ok. Maybe you could get a referral to Neurosurgery FROM your original Neurologist?
User:I can call and see, as I said she discharged me from her clinic, but I can try
Doctor:Ok. To be very honest I think that they were expecting to see a sinus issue.. which is a much more common cause of chronic headaches
Doctor:but that report says your sinuses are pretty ok. I wouldn't think the sinuses are whats causing your issues.
User:oh okay then, hopefully the headaches can be fixed some way then
Doctor:I'm reasonably sure a Neurosurgeon will be able to help you here
Doctor:They are the only branch that handles ICP issues
Doctor:In the meantime.. If you have access to any OTC diuretics (like the drugs that are used for PMS). I would suggest you take one of those
Doctor:If you DO have Idiopathic High ICP then a diuretic may give you some relief.
User:Okay, I am prescribed aldactone which I was told is a diuretic? Inza gives me relief as well, which does help for a few hours pain free :)
Doctor:Good, ok, aldactone is a great diuretic
Doctor:I'm going to have to look up INZA. I am not familiar with that drug
Doctor:one moment
Doctor:Ok it's NAproxen
Doctor:Yes, it should help a bit.. Don't overdo it though, I know your suffering, but i would hate to see you get kidney problems from the Inza
Doctor:I hope I helped!
Doctor:Thanks for coming to HealthCareMagic!
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