How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Frank Your Own Question
Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 8999
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
64994909
Type Your Neurology Question Here...
Dr. Frank is online now
A new question is answered every 9 seconds

Have been diagnosed with a pituitary tumor (Macro) and a

Customer Question

have been diagnosed with a pituitary tumor (Macro) and a Cyst on my Ptuitary Gland, I had an MRI with contrast and they found it, I met a surgeon yesterday and was referred to GWU Hospital (Surgeon is doing that), I have had blood tests 9 of them for Thyroid Etc, T3 T4 etc. They came back ok according to my Doctor.
My complaint was for dull headaches mainly on the right rear side, some vision changes, some dizziness and some pressure on my sinuses. My question I failed to ask him (I was a little off balance when he told me I needed surgery) is that this thing is at the front, can it also cause dull right sided headaches for 5 months now ?. (I did also hit my head badly earlier in the year but did not get headaches until about 3 weeks after). Originally Doc had said Occipital Nueauralgia.
Thanks in advance
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello Welcome to JA. I will review your statement and respond. Please read this preliminary answer and reply if you have questions, I can discuss this until you are satisfied. Dr Frank

Expert:  Dr. Frank replied 1 year ago.

Hello. Some questions. The doctor that thought you had greater occipital neuralgia (GON), did he do a greater occipital nerve block to see if you had improvement? Secondly, if you have sinus symptoms and a history of sinus disease (?), did anyone suggest mastoiditis as a diagnosis? That is an inflammation of the mastoid sinus, which is the bump behind your ear. With that you can get GON, but for that you need to have sensory symptoms on your scalp, albeit tingling and/or numbness along the entire right parietal scalp and occipital scalp that does not cross the midline to the other side. Do you or did you have that? A non-secretory pituitary tumor/cyst cannot cause right occipital pain as there is no known methodology to do that. It can effect your vision, give you pain in the front of your face or around the area between your eyes (glabellar pain), but for that you would have to expect some sort of pressure effect. Please get back to me to discuss by asking questions or adding information and I will respond. If satisfied with this answer, please remember to rate this service as that is how I am compensated for my work. Just click on the rating stars. Thanks *****

Customer: replied 1 year ago.
Dear Doctor I answer your questions
The doctor that thought you had greater occipital neuralgia (GON), did he do a greater occipital nerve block to see if you had improvement? No he did not. he told me it would diminish, on the third visit he reccomended MRI with contrast, when MRI came back with Pituitary troubles I had bloodwork.Secondly, if you have sinus symptoms and a history of sinus disease (?), did anyone suggest mastoiditis as a diagnosis? No they did not, I did have a Sinus infection two months ago.Tingling and/or numbness along the entire right parietal scalp and occipital scalp that does not cross the midline to the other side. Do you or did you have that? Yes I do, I cant say its a headache, but it is a numb feeling on the upper right side of my head, not painful but numb.I do have optical pressure, tiredness and dizziness sometimes, that I guess is the Cyst.Thanks DoctorAlistair
Expert:  Dr. Frank replied 1 year ago.

Yes, you have it correct if we are going with the common responses to these problems. So I would suggest you try a GON nerve block. You mix 2 percent lidocaine with some Marcaine(prilocaine/lidocaine mix) and some Kenalog (glucocorticoid) (1/2 cc) then you have to localize the GO nerve as it exits a foramen just behind the ear. When you feel you have found the "bump" of nerve as it comes out of the skull, you inject around it (not into the nerve of course) the mixture, about 3 to 5 cc. You should have a injection area like a squash ball size. The Marcaine can last a week or so, so you would have some more numbness of the scalp as the lidocaine works first, but then the Marcaine/steroid takes long term effect. If that works for your problem, you have a diagnosis, and can consider another steroid injection or even surgery ultimately if it continues. I hope that helps Please get back to me if you have further questions and I will reply. Dr Frank