Dr. Solanki Chirag Natwarbhai
Neurosurgery
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Patient's Query
Hello doctor,
MRI(Magnetic Resonance Imaging) report shows: Left cerebellopontine angle arachnoid cyst measuring 18 x 12 x 10 mm displacing 9th and 10th cranial nerves ventrally. Misc- prominent bilateral level 3 lymph nodes also left level 2A lymph node measuring 29 x 11 mm. I went to an ENT (Otolaryngologist) because I was dealing with terrible pressure in my head and also pulsatile tinnitus. I constantly hear my heart beating or blood pumping in my left ear. I have had grand mal seizures and a febrile seizure when I was a toddler. In 2018 they did not see anything in my CT (Computed Tomography) scan. ENT referred me to a neurologist for the pressure in my head being migraines and also to a neuro-otologist for the cyst who then referred me to a neurosurgeon that I have not went to due to Covid-19 outbreak. Only procedure I ever had done was an epidural injection in my lumbar for bulging disc, which after the procedure I dealt with massive head aches. Doctor told me they would subside. I am 21 years old. I am just looking to see some opinions on this matter and how it should be treated. Forgot to add in I have been dealing with neck pain also now.
Hello, Welcome to icliniq.com.
I would like to know more about your headache, heaviness in head like the location of pain, frequency, severity, a particular time of the day when it occurs, associated vomiting, nausea or blurring of vision. How long does it last? Does it require medicines to be taken always? I also would like to know tinnitus is in the left ear only? Any medicines for seizures? Also, it would be nice if you can send images of MRI (Magnetic Resonance Imaging) to have a better idea about the arachnoid cyst. Please elaborate on the problems and answer all these questions and send MRI images so that I can suggest you better.
Patient's Query
Thank you doctor,
I am unable to get my hands on my MRI (Magnetic Resonance Imaging) images right now but here is my report. My head aches are usually in the front of the head, sometimes with nausea only once have I thrown up from it. It was happening a little bit more a month ago now I just take an Excedrin once I start to feel it and that usually helps. No particular time in day but not morning at all. I drink plenty of water also but usually always I have to take medicine for it. I am not on medication for the seizures I have had. The pulsatile tinnitus is only on the left side and I have had a hearing test and everything was all good with that.
Hi, Welcome back to icliniq.com.
So considering the headache you have it does not look like migraine nor it is due to the arachnoid cyst. Forehead headache may also be due to sinusitis. In case if you have frequent episodes of common cold, nasal blockage, etc. If you have that you might need to take steam inhalation and consult an ENT surgeon. And for headache, I would suggest continue taking on sos (if Occasion Require) bases when the headache starts or you feel like having it so that it does not increase in intensity. Tinnitus might be associated with an arachnoid cyst or vascular compression on 7-8 complex despite the MRI (Magnetic Resonance Imaging) shows that (according to report) there is not much of a pressure. As such medicines seldom help in such case, but if it is due to ear pathology which has already been ruled out, there might be some help with medicines. If the frequency of headache is not much then prophylactic drugs are not required. I think you need to see a neurosurgeon once the situation is better. To be evaluated by him for the cause of tinnitus. If we had MRI images, it would have been of great help.
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Neurosurgery
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