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What Causes Migraine Headache, Nausea And Bruises On Legs With A VP Shunt?

Posted on Thu, 21 Apr 2016

Question: My 24 year old daughter has a VP Shunt from when she was 2 weeks old (due to hydrocephalus at birth). It was replaced 2 1/2 years ago, when she was 21. She has started getting migraines again, but is now noticing bruising on her legs and arms. There are a number of very small dark purple round bruises (about 1cm in diameter), and others that are larger and not as dark. She is also sometimes pale, cold and clammy feeling most of the time. She experiences dizziness and light-headedness as well, and occasional nausea, but not vomiting. No fever. She is being referred to a neuro-surgeon, but that all takes time. We are wondering what this could be because some of these symptoms aren't normal for a malfunctioning shunt.

Answered by Dr. Neeraj Kumar (1 hour later)

Brief Answer:
Take treatment as advised and get consultation too

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.

Shunt malfunction related headache and vomiting will be continuous, severe and not responsive to medication.

For assessment you need to go to a neurosurgeon. CT scan head may also be required.

Migraine headache are throbbing, unilateral or bilateral, associated with nausea or vomiting, sensitivity to sound or light.

For migraine treatment you need to get her consulted by a neurologist.

Drugs like Amitryptiline, Topiramate, Flunarizine, Divalproate may be tried for migraine prophylaxis.

For acute pain attacks Naproxen, Triptans may be used.

Regular timely meals and sleep and decrease migraine episodes.

Hope you found the answer helpful.

Do get back to me for further queries.

Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Neeraj Kumar (28 minutes later)

Hello Dr. XXXXXXX
It's a coincidence that my daughter's neuro-surgeon back in 1992 was named Dr. XXXXXXX XXXXXXX in XXXXXXX Saskatchewan. Are you related?

You didn't mention anything about the bruises. They are some that are little and round and very dark purple, about 1cm. appearing on her legs and arms. What could that be from?

Thanks, XXXX

Answered by Dr. Neeraj Kumar (13 minutes later)

Brief Answer:
Get investigated and examined for bruises

Detailed Answer:
Hello, Welcome back to HCM.

I am not related to Dr XXXXXXX Kumar.
I am sorry that I've missed regarding bruises.

Bruises at this age needs investigation like blood counts including platelet counts, bleeding and clotting time, PT, INR and APTT.

Any history of drug intake, trauma, family history?

Vitamin K supplementation may be given.

By the way are you sure that those lesions are bruises and not any skin disease manifestation?

Consultation with a dermatologist or physician for clinical examination or images may be helpful.
Also you may upload images of them which can give me some idea regarding it's nature.

Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Neeraj Kumar (17 minutes later)

OK, thanks! She isn't home right now, but I will take pictures and send them to you. We will also get them checked by her Doctor when she sees him and if he feels she needs to see a dermatologist he will refer her to one I'm sure.
Thanks for your time!
XXXX

I uploaded 5 photos of a few of the bruises on her arms and legs. They just seem to appear.

Answered by Dr. Neeraj Kumar (15 hours later)

Brief Answer:
Get investigated as discussed earlier

Detailed Answer:
Hello,
I have reviewed the images.
The petechia and purpura are vascular in origin.
Go through the above mentioned tests.
Hope you found the answer helpful.
Regards
Dr N Kumar
neurologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj