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Suggest Treatment For Persistent Sever Headaches
Hello. I had a vp shunt revision at the end of january after a month of progressively worsening headaches. I am still having very bad headaches 9 months later, am not able to work/ even really socialise as a result. Every time i get ready to go out & when i leave the house my headaches get bad / i get the explosing feeling like before i had the op. The surgeon & gp have no answers & say it takes time but fail to see the severity of the pain or subsequent effects on my quality of life. No painkillers seem to work & i cant find what may be triggering this. Please advise me what i can do/ who to speak to/ be referred to. I m desperate & willing to try anything that may help. Medicine, marijuana, acupuncture, creams etc. Thank you.
Mon, 24 Dec 2018
Hi,
I don't know enough of the details of your VP shunt procedure and why they decided to do the revision?
In other words, was there compelling evidence that the headaches you were having 9 months ago were actually caused by a malfunctioning shunt?
Most neurosurgeons I know are reticent to do a revision just on the basis of headache if the shunt can be shown to be fully functional.
So let's assume for a moment that the revision actually corrected a problem that was present in the shunt mechanism itself.
If your headaches are no better than they were before then, the shunt was never the real problem triggering the headaches. If headaches are better after the revision but still bothersome and poorly controlled then, is it possible that the rate of fluid being shunting is either too high or too low? in other words, after the procedure of the revision along with any changes that were made in the settings, was there any noticeable improvement that then, was lost over time and now the pain is back up? To me that is a potential setting problem.
If the shunt is working and the settings are not an issue then, you may have headaches of a primary or other secondary nature requiring evaluation by a headache specialist (such as myself) but "painkillers" would not be the answer to this sort of situation. We'd need more information on which medications and/or interventions have been actively pursued to determine what the best next course of action should be in your case.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Dariush Saghafi,
Neurologist
I don't know enough of the details of your VP shunt procedure and why they decided to do the revision?
In other words, was there compelling evidence that the headaches you were having 9 months ago were actually caused by a malfunctioning shunt?
Most neurosurgeons I know are reticent to do a revision just on the basis of headache if the shunt can be shown to be fully functional.
So let's assume for a moment that the revision actually corrected a problem that was present in the shunt mechanism itself.
If your headaches are no better than they were before then, the shunt was never the real problem triggering the headaches. If headaches are better after the revision but still bothersome and poorly controlled then, is it possible that the rate of fluid being shunting is either too high or too low? in other words, after the procedure of the revision along with any changes that were made in the settings, was there any noticeable improvement that then, was lost over time and now the pain is back up? To me that is a potential setting problem.
If the shunt is working and the settings are not an issue then, you may have headaches of a primary or other secondary nature requiring evaluation by a headache specialist (such as myself) but "painkillers" would not be the answer to this sort of situation. We'd need more information on which medications and/or interventions have been actively pursued to determine what the best next course of action should be in your case.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Dariush Saghafi,
Neurologist
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