You Be the Doctor: What's Causing Horrible Headaches?

Aug. 11, 2008 — -- Sean Murphy has always had allergy symptoms. He's always had a feeling of vertigo, or dizziness, but never thought much about it.

And then the 33-year-old woke up with a headache -- one that didn't go away for weeks.

"I began noticing headaches that were always in the same area in the back of my head. And primarily, they got worse as the day went on," Murphy said. "They were constant."

When he told wife Natasha Murphy about the persistent pain that had lasted for a couple of weeks, she was shocked.

"I've had migraines in the past," she said, but noted that "none of his symptoms were coming out as anything so benign as a migraine."

Sean described the feeling as having something inside his head, something that "wants to get out more than anything else."

Worsening Symptoms

He began having trouble turning his head and any movement that caused pressure inside his head, such as a sneeze, a cough, a laugh or a yawn, was excruciating. And he was having a hard time keeping up with his kids.

At his wife's insistence, Murphy went to see a doctor.

"He didn't have any signs or symptoms of anything like meningitis," which can cause persistent, severe headaches, Dr. John Bjorklund said.

But what he didn't rule out was something structural, possibly a tumor or some kind of mass growing in Murphy's head.

Initial brain scans showed a minor abnormality, something the radiologist couldn't define. But Murphy was starting to have difficulty swallowing, tingling sensations in his extremities and memory loss. He was also having a hard time telling the difference between hot and cold in his fingers and toes.

So Bjorklund referred Murphy to a specialist.

The doctors then noticed what might have been a small lesion on the inside of his skull, a type of tumor known as a meningioma.

"I just couldn't believe that that little speck could be causing the amount of pain that I had been feeling," Murphy said.

Still No Diagnosis

Eventually, Murphy saw a neurosurgeon. The doctor walked in and told the Murphys, who had been expecting surgery, that he wasn't a good surgical candidate. Murphy was sent back to his neurologist.

Murphy, who by then was on narcotic painkillers, said the news was a crushing blow, like a "house of cards came crashing back down again."

"The meds also took him a little away from me," Natasha Murphy said. "He was less there."

Murphy tried some other treatments, including an injection in his neck. But while the treatments provided some relief, their effects lasted only a few hours.

"I just was about at the end of the rope," he said.

So Bjorklund recommended Murphy get a second opinion from another set of doctors. The Murphys took advantage of their own backyard and headed to the Mayo Clinic in Rochester, Minn.

There, Dr. Michael Cutrer examined Murphy and found everything to be normal. After listening to his recap of symptoms, Cutrer ordered another MRI of his brain.

After the test, Murphy said, Cutrer looked up "and said with a twinkle in his eye 'I think I know what you have.'"

The Diagnosis

"He talked about this, this, I don't know, thing I'd never heard of called Chiari Malformation Type 1," Natasha Murphy said.

"Dr. Cutrer pulled the film up for me and said, 'See right here? These are called your cerebral tonsils. In a normal person, they're not there. They're about a centimeter or two higher inside the head than where yours are,'" Sean Murphy said. "'And you can see here, they're constricting your spinal cord.'"

Murphy's skull was too small for his brain to fit inside. And his brain was squeezing out through the hole at the bottom.

"Essentially, it is the mother of all pinched nerves at that point," he said.

Cutrer referred Murphy for a neurosurgical evaluation with Dr. John Atkinson. In people with Chiari, Atkinson explained, the back of the skull doesn't grow normally during childhood.

The procedure to treat the abnormality is to make the back of the skull larger.

So Atkinson removed what he described as a 50-cent piece of the back of Murphy's skull.

"We've opened the membrane and made it larger," he said, "and sewed on this patch to create a larger space for the back of the brain to hang."

Natasha Murphy said she and her husband knew better than to take any surgery lightly.

"But we kinda kept a positive attitude and said, 'You know what, we're gonna get through this,'" she said.

"I had personally never had major surgery before -- had no idea what to expect," Sean Murphy said.

Out of the Fog

But this one worked. Waking up from surgery, he said, was like "coming out of a dream, out of a fog."

While he had a headache from the four-inch incision in the back of his head, that lessened during his recovery.

"I had no more headache. I had no more pressure," Murphy said. "I could laugh. I could sneeze. I could yawn."

Not only that, but his lifelong struggles with allergies and dizziness disappeared after the surgery as well.

"There's no reason he can't do anything and everything he wants to do," Natasha Murphy said.

And Murphy?

"I never knew this is what life was."

CLICK HERE to learn more about Chiari Type I Malformation.