Full Question:

Can anyone tell me what is going on with the blind spots that have remained after I had a visual migraine over a year ago, June 2007? I had no headache afterwards - but these small spots to left of my visual field have remained.

If reading a word and put my focus on one letter in the word, I don't see the preceding two-three letters, but if reading a long word, any letters before these spots I'm again be able to see.

It seems the outline of the crescent that appears during the visual migraine has somehow remained, because when I try to track what is "erased" in my vision it goes up above and a little below the center of my focus. It's not in the center of my focus, but around it. Some parts of vision are erased and some are distorted, like looking through a cracked window. However, all my vision around this crescent is normal.

At times it is more noticeable and annoying depending on the kind of lighting in the room. At times this permanent "crescent" has flickers of color and I can see the outline of a zig-zag or lightening bolt, typical of a visual migraine, but it doesn't "grow" from left to right eventually covering my entire visual field, which is typical for me when I have one.

Sometimes when it appears I am beginning to have a visual migraine,   it doesn't run its course as usual, but it seems like it is somehow active.   Can you tell me what is going here? Will this get worse? Is it dangerous or life threatening? Is there anything I can do to stop them?   Will the blind spots ever go away?   Could it be from a blocked blood vessel, some kind of tumor in the occipital lobe of my brain, or an arterio-venus malformation (AVM)? I had an AVM treated via gamma ray radio-surgery 11 years ago.

In my early twenties I had   my first visual migraine.   I then usually had one or two a year.   In my late thirties and forties (now 45) I've had anywhere from one or two a month, to having three or four in one day, but it varies.   I have no head pain or headache.   Sometimes, especially if I have more than one a day I will feel severe pressure in my head. Should I get more extensive testing?

I saw both an optometrist and an ophthalmologist that tested my eyes and could see no scarring, or infarction in my cornea, no sign of a stroke, there seemed to be no tearing of the retina.   They both could tell me nothing.   They said everything looked fine to them and according to the tests nothing showed up.

What do you think? Leslie.

Answer:

Dear Leslie,

It would be helpful to know what type of Migraine you experienced. The term "visual Migraine," may be descriptive, but it's not a type of Migraine. We can only assume you had one type of Migraine with arua -- either "regular" Migraine with aura, basilar-type Migraine, or hemiplegic Migraine. In any case, symptoms of a Migraine that occurred a year ago should have resolved by now.

Has your doctor run an MRI, MRA (magnetic resonance angiogram), and MRV (magnetic resonance venogram) to rule out stroke and TIA?

The answer to your question of whether this could be a result of a tumor or AVM is yes, it could, but there is simply no way for anyone to tell you via the Internet. It could also be an acephalgic Migraine with aura (See Acephagic or Silent Migraine - The Basics.) or something else entirely. Bottom line is that you need to find a doctor who will not give up until he or she has an answer for you. There's a link below to our directory of patient recommended Migraine and headache specialists.

Good luck,
John Claude Krusz and Teri Robert

About Ask the Clinician:

Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.

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