AVM and Migraines

[duncan001]

My wife has had migraine headaches for over ten years.  She has been on several medications both for pain and nausea.  None of which do more then take of the edge and allow her to sleep.  She is debilitated by them and on a few occasions I have had to take her to the ER for a shot.  I realize that Migraine is a big mystery and there is little else to do but medicate and try to identify/eliminate the triggers.   But we've been unable to identify my wife's triggers and they seem to be coming much more often.  Recently I saw a diagnosis show on TV which dealt with another symptom that my wife has (Seemingly unrelated)Numbness and tingling in her forearms, hands and fingers.  My wife's Doctor at the time diagnosed Carpel tunnel and they performed an operation on her wrist to alleviate the constriction on the nerves.  It did not effect the symptoms.  She describes it as severe pins and needles almost constantly as did this woman on the TV program.  This woman's eventual diagnosis was first a Cavernous angioma and then lastly an Atrio-venal malformation in her neck.  (Two sides of the same coin I gather depending on flow rate).  Also I learn that these blood vessel defects are commonly a cause for severe headaches.

What are the chances that she has one cause for both these symptoms?

She says that the have done MRIs on her head and would have detected them????

One other note,  Her headaches are typically accompanied by high fever  A symptom I don't read often in the migraine literature but common in the literature for AVM.  Otherwise her headache symptoms are typical , visual defects, nausea, etc.
Any info on this would be appreciated,  
Thanks Duncan  

[Dr. Kokil Mathur]

Hi
Thanks for writing to the forum!
I read through your post. Based on the information provided by you, I think your wife could be suffering from polyarteritis nodosa which can cause headache with fever, tingling, visual defects etc.
Cavernous angioma and arterial-venous malformation can also be looked into.
Another possibility is ‘benign intracranial hypertension’  (BIH). This happens due to impaired CSF absorption. A generalized throbbing headache worst felt in the morning and last thing at night. This headache is generally relieved on standing (consistent with raised intracranial pressure). It is aggravated by straining, coughing or a change in position. You have a similar headache.
The second most common symptom is visual defect, which she also has.
Hypothyroidism, hypoparathyroidism, adrenal insufficiency are a few things I would recommend she gets investigated for. These can precipitate BIH. A spinal tap is a must both to diagnose the condition and to treat it.
Hope this helps. I think you should discuss these possibilities with your doctor. It is difficult to comment beyond this without examining. A comprehensive investigation is required keeping all the points in mind. Please let me know if there is any thing else and do keep me posted. Take care!

[duncan001]

Thanks for the info.  We'll do a little more research and hopefully She and her Dr. can get a little more proactive.
Duncan