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Question
Posted by: M | 2009-04-14

Headaches after operation

I had a dermoid cyst removed from my brain in 1997. Before and since then I have a headache every single day of my life. I went for a MRI and they said that the place where they removed the cyst is still visible. They wanted to compare this result of the MRI with the previous one I had because they saw that there was " something"  on my brain. Apparently it was that. I do take grandpa' s to help with the pain and sometimes a tripeline.

I get pins and needles in the left side of my face and then my face starts to swell. Sometimes it is so painful I can' t sleep on my left side. I cannot swallow either when I lie on my left side. I want know why my face swells and sometimes the pain is to severe that the left eye starts to tear as if I am crying out of my left eye.

What causes this and can a dermoid cyst cause a tumor or something? I also have major depression and anxiety disorder, does the headaches have something to do with this?

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Our expert says:
Expert ImageHeadache expert

Dear M,

It is highly unlikely that your headaches are coming from your brain, or the place where the dermoid cyst was removed.

If your face swells, has pins and needles and is painful, then the most likely cause is painful spasm of the muscles that you chew with. This would also explain the tears and the pain when you try and swallow when you lie on your left side.

It is very common for someone with constant pain to suffer from depression and anxiety – when the source of the pain is located and treated, these other symptoms often improve or disappear.

To get to the root of the problem, you need what is called a “multidisciplinary assessment”. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension, and of the external carotid vasculature to determine whether there is an arterial element to the pain.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on http://www.headacheclinic.co.za/

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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