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What Causes Pressure Sensation Around The Eyes And Headaches?

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Posted on Thu, 16 Feb 2017
Question: i have partially empty sella and my optimologist says there is no pressure any more arond my eyes but i am having bad head aches what should i do
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Answered by Dr. Dariush Saghafi (51 minutes later)
Brief Answer:
Not an unusual finding in your age group or gender

Detailed Answer:
Good evening. The empty sella turcica is not an unusual finding in many women and in fact, is actually relatively common as radiographic phenomenon go WITHOUT correlated clinical features. If your ophthalmologist has told you that there is no pressure seen in your optic discs of any significant nature then, he/she are telling you that you do not have PAPILLEDEMA....I don't know if that's what you had before or if someone thought you may have had such a thing and then, sent you for an MRI of the head....or whether someone scanned you thinking you might have something such as IIH (Idiopathic Intracranial Hypertension).

At any rate, the upshot of the results and what your doctor told you is that your next move is to see a NEUROLOGIST or even better yet....a headache specialist who is still a neurologist but with a headache specialization. One of 2 things will happen. Either they will agree that your headaches are UNRELATED to the previous concern of increased intracranial pressure which the ophthalmologist cannot verify from lack of papilledema (swelling of the optic nerves) or the neurologist will look at the MRI and still be suspicious that your headaches could be related to something intracranial despite the ophthalmologist's opinion and work to try and do further tests to rule things out such as either a CONTRASTED study of the brain by MRI which is sometimes recommended in the face of an empty sella in order to look for other odd things that could cause INTERMITTENT increases in pressure in the head such as 3rd ventricular COLLOID CYST...sometimes missed if studies do not get done with intravenous dyes. Or the neurologist might suggest a lumbar puncture to actually physically measure the pressure in the head.....unless the ophthalmologist already did that....I'd be very surprised if an ophthalmologist would take that route since it is usually either the domain of the neurologist, neurosurgeon, or interventional radiologist to do that sort of thing.

Bottom line? My next point of departure would take me to a NEUROLOGIST's or HEADACHE SPECIALIST's office for a further consultation on these results which still leave you with headaches.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 25 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dariush Saghafi (49 minutes later)
thanks so much i did have in the past (Idiopathic Intracranial Hypertension) and i had a spinal tap done and then took lasix and now my nuro ophthalmologist's said it looks all better but the head aches are still there but not the same as before but still wakeing up at night
so you feel there is still a possibility that there is a chance that there is pressure although my eyes are better?
doctor
Answered by Dr. Dariush Saghafi (4 hours later)
Brief Answer:
I am currently taking care of a patient with IIH--- ZERO papilledema

Detailed Answer:
It is rare but possible to have absolutely no PAPILLEDEMA but still have IIH.....also it depends on how good your neuroradiologist is who is reading the MRI because in this gal's case there were 2 other radiologists who read her scan as normal. She continued to not only have headaches but she had other classic types of complaints and symptoms of IIH such as numbness and tingling of the face (almost never happens exclusively in migraines or any other type of primary headache) as well as TINNITUS (ringing in the ears).

However, what I've described is RARE....NOT COMMON.....probably publishable if you find it.....sooooo what I think you likely have is either a long term residual of the IIH in terms of headache or there is still elevated pressure measurable by doing a spinal tap but not necessarily by looking at the fundi of the eyes. Therefore, I recommend you get someone who can really work with your headaches to figure out whether or not they are PRIMARY (i.e. not due to anything except genes and "bad luck") or secondary (i.e. as a result of IIH...or something like IIH).

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 42 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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What Causes Pressure Sensation Around The Eyes And Headaches?

Brief Answer: Not an unusual finding in your age group or gender Detailed Answer: Good evening. The empty sella turcica is not an unusual finding in many women and in fact, is actually relatively common as radiographic phenomenon go WITHOUT correlated clinical features. If your ophthalmologist has told you that there is no pressure seen in your optic discs of any significant nature then, he/she are telling you that you do not have PAPILLEDEMA....I don't know if that's what you had before or if someone thought you may have had such a thing and then, sent you for an MRI of the head....or whether someone scanned you thinking you might have something such as IIH (Idiopathic Intracranial Hypertension). At any rate, the upshot of the results and what your doctor told you is that your next move is to see a NEUROLOGIST or even better yet....a headache specialist who is still a neurologist but with a headache specialization. One of 2 things will happen. Either they will agree that your headaches are UNRELATED to the previous concern of increased intracranial pressure which the ophthalmologist cannot verify from lack of papilledema (swelling of the optic nerves) or the neurologist will look at the MRI and still be suspicious that your headaches could be related to something intracranial despite the ophthalmologist's opinion and work to try and do further tests to rule things out such as either a CONTRASTED study of the brain by MRI which is sometimes recommended in the face of an empty sella in order to look for other odd things that could cause INTERMITTENT increases in pressure in the head such as 3rd ventricular COLLOID CYST...sometimes missed if studies do not get done with intravenous dyes. Or the neurologist might suggest a lumbar puncture to actually physically measure the pressure in the head.....unless the ophthalmologist already did that....I'd be very surprised if an ophthalmologist would take that route since it is usually either the domain of the neurologist, neurosurgeon, or interventional radiologist to do that sort of thing. Bottom line? My next point of departure would take me to a NEUROLOGIST's or HEADACHE SPECIALIST's office for a further consultation on these results which still leave you with headaches. If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out. Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. This query has utilized a total of 25 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.