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Suggest Treatment For Headaches And Blurred Vision
Question: I still have headaches on a daily basis after 6 mo after pipelinhyee stent for a nonruptured aneurysm just had 6 mo followup and it is almost gone with no leakage so why are my headached still persists I also have blurred vision in 1 eye as aneurysm compromised my optic nerve my headaches are on the side of my head will they ever go away now they are saying migraines I never had headaches before this they are very debilitating and seem to always be lingering all day
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Chronic headache after a subarachnoid hemorrhage is common. It can persist for months or even years. Cause is not well understood, is thought due to cellular injury from the hemorrhage, at a microscopic level not visible by imaging, leaving altered neurotransmission and blood flow changes. There are few studies regarding the most appropriate preventive treatment for this type of headache unfortunately.
Amitriptylin would have been my initial choice as well, I do not know what dosage you took it, might still try to reduce the dose.
If that doesn't work other options would include the other classes for migraine prevention, such as anticonvulsants like valproic acid and gabapentin, or another antidepressant with less sedating properties then amitriptyline. Not all have the same efficacy or side effects in different patients so may have to try more then one.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
I read your question carefully and I understand your concern.
Chronic headache after a subarachnoid hemorrhage is common. It can persist for months or even years. Cause is not well understood, is thought due to cellular injury from the hemorrhage, at a microscopic level not visible by imaging, leaving altered neurotransmission and blood flow changes. There are few studies regarding the most appropriate preventive treatment for this type of headache unfortunately.
Amitriptylin would have been my initial choice as well, I do not know what dosage you took it, might still try to reduce the dose.
If that doesn't work other options would include the other classes for migraine prevention, such as anticonvulsants like valproic acid and gabapentin, or another antidepressant with less sedating properties then amitriptyline. Not all have the same efficacy or side effects in different patients so may have to try more then one.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I did not have a SAH mine was unruptured I was told that chronic headaches can cause stroke if not controlled what about my eye, do you think my vision will come back after total embolization? I have no other health risks this came out of the blue. it was located in ICA on 3rd cranial nerve pressing the sphenoid bone and optic 4.2 so it was a small one but my eye was dilated with blurry vision headache and nausea and since I had strong symptomology they said I needed to get it taken care of before a bleed
Brief Answer:
Read below.
Detailed Answer:
Thank you for the additional information. You have indeed precised that it was an unruptured aneurysm, I should have been more careful and I apologize about that, it shouldn't have happened. It makes the cause of the headache less clear, probably due to the prolonged compression causing over-sensitivity of the pain pathways in the meninges. In terms of medication though I still wouldn't change anything from the previous suggestions about headache prevention.
Regarding the regaining of normal vision that depends on the degree of damage the prolonged compression did to the nerve. There is no test to determine that, regeneration degree varies from person to person. Nerve regeneration takes time, usually most of it occurs during the first 3-6 months, but may continue for up to one year so it is early to lose hope.
As for the notion that chronic headaches cause stroke that is not true, you do not have to fear about that. There is an increased risk of stroke in people who suffer from migraine for many years, but I wouldn't classify you in that category, yours is a particular case which is not a true migraine, studies about added risks in migraine patients do not apply to you. Headache in itself doesn't confer a risk for stroke.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Thank you for the additional information. You have indeed precised that it was an unruptured aneurysm, I should have been more careful and I apologize about that, it shouldn't have happened. It makes the cause of the headache less clear, probably due to the prolonged compression causing over-sensitivity of the pain pathways in the meninges. In terms of medication though I still wouldn't change anything from the previous suggestions about headache prevention.
Regarding the regaining of normal vision that depends on the degree of damage the prolonged compression did to the nerve. There is no test to determine that, regeneration degree varies from person to person. Nerve regeneration takes time, usually most of it occurs during the first 3-6 months, but may continue for up to one year so it is early to lose hope.
As for the notion that chronic headaches cause stroke that is not true, you do not have to fear about that. There is an increased risk of stroke in people who suffer from migraine for many years, but I wouldn't classify you in that category, yours is a particular case which is not a true migraine, studies about added risks in migraine patients do not apply to you. Headache in itself doesn't confer a risk for stroke.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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