Migraine

Are these common triggers? I have noticed them more and more the past year or so.
Also it seems that wearing my reading glasses is a trigger!

I am wondering if they are standard headache triggers of if they have more to do with my psuedotumor cerebri?

be blessed-
Dawn

I've never gotten a headache from either coughing or sneezing, but on quite a few occasions when I've been laughing hard, I've had sudden and intense headaches that start up the back of my head. It almost feels like there's a rush of blood flooding the base of my skull. I did make sure my neuro knew about it, and he didn't seem concerned about there being any inherent danger. I do know that if you do suffer headache with either of these three things, it's important to let your doctor know as soon as you can, in case he or she feels like anything needs to be checked out past deciding that it's some kind of trigger. Please let your doctor know. As for the glasses, I've got no idea what might be happening there.

These are common headache triggers for Chiari Malformation. Some people who have IH also have Chiari.

I guess I will ask at Mayo if this is from the IIH or migraine or what. Chiari would be visible on an mri right? I have had MRI of brain w/ w/o contrast and a cervical spine mri so they would have caught it at that time, right? I have also had CT angiography, CTs, MRA's and xrays numerou stimes over the past 25+ years. I should glow in the dark and pulse with magnetic waves LOL.

All I know is I was laughing a lot last night and I just couldn't believe the occipital pain and the migraine I got! I was begging people to quit making me laugh. It is definitely getting worse!

Thanks for the information!
be blessed,
Dawn

A Chiari would mos DEFINITELY be viewable on an MRI. I have a disputed Chiari...I guess one cannot call it that without a proper Rx but my cerebellum does hang down out of my skull.

Another theory is the PFO theory. A PFO is a small channel-like opening between the two upper chambers of the heart. Normally it closes after birth, but statistically 25% of adults will still have an open PFO. In some cases of Migraine, this hole has been connected with aura and other sensory phenomena associated with Migraine. However, recent trials designed to study the link between a PFO and Migraine have been dodgy at best. These holes can vary in size, which may have something to do with the population that has a large hole and also Migraines with Aura. A larger population of Migraineurs with aura have been found to have this hole.

The theory is that during straining, coughing, or any other activity that may put pressure on the heart causing the hole to open wider may allow small clots and unoxygenated blood through to the brain. This may trigger the migraine or make it easier for the brain to trigger from other stimuli.

The exact relationship is not yet known. Many people have had their migraines fully reversed after experimental PFO closure; while people like myself have only gotten worse (though I still have a large residual shunt that is being investigated).

Unfortunately PFO closure for Migraine is not recommended or allowed by the FDA since the procedure is controversial and a link between the two hasn't yet been firmly established. There is, however, plenty of anecdotal stories that a PFO closure in stroke patients ease their Migraines. That's partly how they came to this theory, thanks to the reports of these stroke victims whose cause of stroke, other than the presence of a PFO, could not otherwise be confirmed.

Chiari is diagnosed via MRI, but radiologists often miss it. My daughter Anna had four MRI's from 2001 to 2003 at two different clinics/hospitals. Her Chiari was missed each time. Mayo Clinic looked back at her MRI's and confirmed that radiologists had missed it. Many Chiarians have gone up to five years before being diagnosed. Chiari is rare, and radiologists often are not looking for it on MRI's.

We have taken Anna to Mayo several times for both Chiari and IH. They are pretty good about diagnosing Chiari, but they are not popular on Chiari forums (as far as decompression surgeries). We did not chose them to decompress Anna in 2005, nor were they not really willing to deal with her shunt issues last year. Still we have been there several times because we live in Minnesota.

Just to give you a heads up on going to Mayo...they told us to plan on being at Mayo for seven to ten days the first time we went. We got to Rochester in the morning, rented a hotel room, and went to her initial appointment with a neuro. She received a referral in that appointment to see a neurosurgeon, but the appointment was not for two weeks. Luckily when we went back to our hotel, they let us check out without any charge.

Any time we have taken her to Mayo, it has been at least two weeks before getting the next appointment. We do live in Minnesota, and I don't know if they pay attention to where you live. But I have heard this from others--the need for going back and not getting appointments lined up in a row (as you might expect when they tell you to plan on staying for a week or so). We have never even spent one night in Rochester.

It wasn't a big hardship on us, but I just thought I would mention this. Best wishes!

Leelo- A few years ago I had a trans-oesophageal echocardiography. They put a transducer down your throat to envision behind your heart. It was ordered by a stroke doctor at a hospital I don't go to anymore after he heard my heart "clicking". I can't remember exactly the terminology he used but I suppose I might have a small PFO? He did say there was a small hole in my heart letting blood leak between chambers but it was a very small hole and nothing that needed treatment. (That was one of the "ickiest" feeling tests I have ever had and am not in a hurry to have it ever done again. It didn't hurt...it just felt really creepy!) Now I am thinking perhaps I should see if there is any way to get that medical record to keep with my others- I woulds at least be reminded of the diagnosis......Thanks for mentioning this! Wouldn't they have noted this on the 2 angiograms I have had in the past 4 years (which they said were good)? That seems odd to me.


Annas Mom- Thanks also for the points regarding Mayo. I have been there once before about 5 years ago. At that time I was there for a full medical workup to help sort out all the meds I was on but only saw the neurologist once. I actually did have several different appointments with different docs in a 2 or 3 week period and then went back and attended their Pain Rehab Center for my back and fibro issues. The whole time they pretty much ignored the IIH issue......so I don't know if that is because they didn't think I had it or because I was already under treatment or what.

Anyway I have made my reservation with the understanding it could be up to 2 weeks but they said there would be no penalty if I left early and should not be a problem with staying longer if needed.

Be blessed!
Dawn

Dawn, I wish you well as you go back to Mayo. I hope they can help you in some way.

Cheryl

Hi everyone

Yes, laughing, coughing and sneezing can all be part of IIH. Whenever the pressure builds in our heads, and we can't reabsorb it properly, it may cause more symptoms.

Ah, I see! Thanks for the info Nancy!

be blessed-
Dawn

Hi Dawn,

I just had a TEE in June too. Did he term the hole a PFO? Because there are also ASDs (which a PFO is an ASD also), but the term is generally used for a hole between the two lower chambers of the heart, which can be deadly. If he didn't seem concerned, then it might be a PFO. There is a lot of discussion and disagreement on what exactly a PFO means for patients with MWA.

Since most doctors don't believe or put stock in a PFO relating to migraine it's not surprising that they did not mention it on an angiogram. Particularly if they weren't looking for it. Plus, it is a fairly common defect...Sometimes size does matter in relation to MWA, however. Not everyone who has a PFO has migraine, but a considerable number of people who have migraine have a PFO. Mine, in particular, is 14mm wide.

Did you have a stroke or a TIA? I ask because this defect has been linked to strokes for patients under the age of 40, when no other cause such as deep-venous thrombosis can be found. The FDA and most insurances OK a closure procedure for patients who have suffered 2 strokes and failed blood-thinning therapies, such as coumadin. I did not have a stroke, but entered into a study of PFO closure on patients with MWA. With a stroke not apparent, it's the straw I grasped at for a cure.

There are some reports that a PFO may enlarge with age.

If I were you I would have the records on hand. I have copies of my closure procedure and the last TEE and TTE I had. My residual shunt is still large, however, and my migraines got worse after the procedure, and I developed permanent aura. There is always a risk of these things, so before investigating further I can tell you from experience to think long and hard about it. With my doctors trying to push St. Jude's into another closure surgery for me, I am almost chickening out because I just keep getting worse. My new cardio said it was possible another closure will push me over since this one went awry, so I am having doubts...But many have benefited from it as well so who knows? I am getting fairly desperate to have my migraines resolved.

If it makes you feel better I also have 2 regurgitating valves which no one talked to me about until I got my hospital records. So sometimes you get a surprise when you get your records. I also have a heart murmur and an irregular heartbeat with palpitations. All of this seems so minor but it's frightening too.

Sorry for the textbook...if you have any more questions feel free to ask.

Take care!

quote:

Originally posted by myachinghead:
Leelo- A few years ago I had a trans-oesophageal echocardiography. They put a transducer down your throat to envision behind your heart. It was ordered by a stroke doctor at a hospital I don't go to anymore after he heard my heart "clicking". I can't remember exactly the terminology he used but I suppose I might have a small PFO? He did say there was a small hole in my heart letting blood leak between chambers but it was a very small hole and nothing that needed treatment. (That was one of the "ickiest" feeling tests I have ever had and am not in a hurry to have it ever done again. It didn't hurt...it just felt really creepy!) Now I am thinking perhaps I should see if there is any way to get that medical record to keep with my others- I woulds at least be reminded of the diagnosis......Thanks for mentioning this! Wouldn't they have noted this on the 2 angiograms I have had in the past 4 years (which they said were good)? That seems odd to me.