Severe headaches and nasuea

[ColtonB]

Severe headaches until age 5 when diagnosed with an arachnoid cyst which was blocking the CSF from draining correctly.  Cyst removed and shunt inplanted which dropped headaches to a 4 out of 10.

Age 13 headaches increased to level 8, shunt malfunction, revised in feb 07,  headaches dropping back down to a level 4. This level is considered tolerable by my son.

March 08 headaches increasing and constant, varying from 6  to pain level 8 throughout the day, shunt appears to be working correctly,  April, CT scan normal, eye pressure test normal, a test where they put radioactive material in the shunt to confirm CSF fluid is draining properly (although draining at a little higher rate than normal) May, Ibuprofen high dosages no effect, June, put on Midrin, 25mg 4 tablets daily, no relief. August Tramadol 50Mg every 6 hours as needed, no effect.  Sept. another eye pressure test, no excess pressure.  October, Nortriptyline, 50mg tablets, 5 times daily, no effect. Getting to sleep is a problem.  November, MRI everything normal, nausea starting as headaches are constant but staying at a level 8 for several hours per day.  December, spinal tap, normal range, new meds Divalproex 500 MG, 4 tablets per day, no effect, naseau more often and more severe, starting to sleep 1 or 2 hours in the afternoon, very unusual for him.  January, headaches 8 to 9, constant, naseau to the point of vomiting and more frequent.    Any pressure applied to back of his neck, temples or where is shunt is immediately increases the pain in his head. The pain is always in the front of his head and equal on both sides. My son asked me,  "DAD, what am I going do?"  I do not have an answer and it is getting worse by the day.  Any suggestions or ideas would be GREATLY appreciated.

[ColtonB]

Thanks, I haven't tried Inderal yet for my son.   We will give it a try.  I have been researching botox injections for the back of the neck, and other specific facial areas that seem to show very good results for migraine and tensions headaches.  Have you heard of any similar studies?
Thank You

[DrNoopurMD]

Hi,

Thanks for writing.
It is difficult to give a straightforward answer without a clinical exam. However since all the tests including spinal tap, MRI, CT scan are normal and the shunt seems to be draining adequately, shunt malfunction or overdrainage and infection can be ruled out.
The possibilities that come to mind are shunt headaches and migraine. Shunt dependent children have been known to suffer from migraine variant. Migraine meds like Inderal have shown dramatic results in such children.
I would suggest you to discuss these two possibilities with his treating doctor.