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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5331
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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My husband has been experiencing constant migraine symptoms

Resolved Question:

My husband has been experiencing constant migraine symptoms ie blind spots, flashing lights etc, no painh
He is 79 years old, recently had a blow to the head
which he feels may be the cause of the sight
disturbances. Could this be possible?
Submitted: 3 years ago.
Category: Neurology
Expert:  Dr. Bob replied 3 years ago.

Dr. Bob :

Hello. Do these visual disturbances occur in both eyes?

Customer:

hhappens in both eyes

Dr. Bob :

How long has this been going on? Did he have this before the blow to his head?

Customer:

not constantly,he has this symptom all the time for 2 weeks

Dr. Bob :

Is it getting any better with time?

Customer:

no, the blind spots and disturbances are staying the same

Dr. Bob :

but they come and go?

Customer:

no, it's continuous, the blind spots being most worrying

Dr. Bob :

were his optic pressures normal?

Dr. Bob :

does he have glaucoma?

Customer:

raised, 22 in one eye

Customer:

no

Dr. Bob :

Head injuries, even relatively minor concussions, can cause temporary visual disturbances, or worsen a pre-existing condition. Assuming his pressures are good, this could last a few weeks, perhaps a couple months.

Dr. Bob :

Has he been having any other symptoms of his concussion...headaches, memory problems, difficulty concentrating, etc?

Customer:

hheadache once or twice, mood changes

Dr. Bob :

Did he have an MRI scan in the aftermath of his head injury?

Dr. Bob :

The problem with head injuries is that the neurons can get damaged. This can occur in any part of the brain, including the parts that transmit or interpret signals from the optic nerves. Most processing of vision, for example, is done in the back of the brain (i.e. the occipital lobe) so a blow here can affect vision for some time, as the neurons slowly heal.

Dr. Bob :

This damage may or may not show up on CT or MRI. Often, it does not because it is microscopic in nature.

Dr. Bob :

This type of neuronal damage cannot be seen during examination of the eyes...unless they are causing increased intracranial pressure, which can be assessed by MRI or lumbar puncture.

Dr. Bob :

In any case, the affected neurons need time to heal, and this healing process is typically very incremental, requiring weeks or months to improve, rarely a year or more.

Customer:

no, he had no treatment or scans, in fact, he did not think it was serious until the sight disturbances started, but this was some time after the head injury.

Dr. Bob :

If he has developed new, otherwise unexplained, neurological symptoms, it would make sense to check an MRI of the brain.

Dr. Bob :

He might also want to be evaluated by a TBI (traumatic brain injury) specialist...otherwise known as a physiatrist.

Dr. Bob :

They have specialized training and expertise in diagnosing head injuries (and the symptoms can be quite subtle) and treating the consequences. The can also arrange for detailed cognitive testing to see what deficits he might have, and how severe they may be.

Customer: Thank you Dr Bob, this was very useful information.
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