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What tests should be done to diagnose severe migraines and persistent pain in eyes?

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General & Family Physician
Practicing since : 2005
Answered : 2600 Questions
36 yr old female 127 lbs hypertension 200/100 etc with severe migraines pressure exploding type migaines back of head, side of head, pain persistant in left eye and sometimes both! No diagnosis But chronic daily migraines for 29 yrs , beginning stages of glacoma, but pressures in the eye normal. nvr had spinal tap, mra, could this still possibly be high intracranial prrssure from read ing my syptoms point there.....what testing should be done?
Thu, 12 Apr 2012 in Headache and Migraines
Answered by Dr. Prasad 7 hours later

Thanks for your query.

From what I understand, you are suffering from chronic daily headaches along with multiple other conditions - hypertension, left eye problems, glaucoma, treated sinusitis, and Migraine can produce daily headaches - visual error/scotoma, chronic recurrent sinusitis, stress, glaucoma, acclerated hypertension, intracranial abnormalities and so on.
You have reported of many of these conditions. Perhaps they could also be contributing to the headaches.

Hence I would advice you to consider addressing the symptoms individually. Proper and regular antihypertensive treatment, regular intraoccular pressure monitoring, eye and sinus check up, appropriate destressing measures along with prophylactic anti migraine medications will contribute significantly in treating daily headaches.

Now to answer your query, high intracranial pressure can be suspected if the intensity of headache has increased these days. And yes, brain scans and MR angiogram could definitely be useful in ruling out neurological conditions as the cause of daily headaches.

Hope my answer is informative and adequate. Should you have any more concerns, I am available to address them.

Above answer was peer-reviewed by
Follow-up: What tests should be done to diagnose severe migraines and persistent pain in eyes? 2 hours later
Yes they've worsened significantly, this is why I suspect pressure issues. I am going to a new specialist soon at university of michigan, so I will ask for that testing. The only recent test they gave me in er was a c t that was normal, however my grandfather died of brain anuerysm at age 32 so the rising bp concerns, me. I am unable to even work part time and am a teacher. I know my triggers and have taken profalactic meds in every category since I was in my teens so I am looking for nonmedicated procedures . Sick of medicine but cant cope without it unfortunately. Im very frustrated because the triage u of m dr said stay on all meds to be prescribed by my family dr but hes sick of treating a problem he knows little of ans is afraid of giving me pain meds , until I get to this specialist should I look for another dr or would it look LIKE dr shopping because I know its a sensative issue. How do you suggest I make this clear to my dr , im seeing him tomorrow and am very dissapointed he isnt following the drs suggestion until I get proper treatment again. IVE BEEN WITH HIM 12 yrs so I cant beleive hes ignoring me although it takes 3 hrs wait to even see him and hes way too busy. Last set of question...thanks you for your advice.
Answered by Dr. Prasad 3 hours later
Hi and thanks again.

I understand your frustration. Let me suggest some information that may be helpful.

It is true that migraine headaches are better prevented with regular and daily prophylactic medications. However the role of stress, proper sleep and avoiding triggers have been acknowledged by all experts. You are doing a good job by avoiding triggers. I would also suggest you to follow destressing measures such as regular diet, proper sleep, transcendental meditation, yoga and physical exercises.

Treatment can be better planned with the expertise of a neurologist / physician and a good GP.

You also must have read about alternative medical experts promising results with acupuncture, homeopathy and natural medicines. This is also an option available.

As far as further testing is concerned. It is good to hear that CT brain scan was normal. But, in view of family history of aneurysm's and worseing headaches, MR angiogram is advisable. You may discuss this with your Neurologist directly and get the test done under his guidance.

Hope my answer is adequate and appreciable.

Wish you good health


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