Head Masses: Symptoms, Causes, and Treatment Options - Neurosurgery

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Understanding head masses, especially in the context of past trauma, is crucial for determining their potential impact on your health and well-being. Based on your description, it seems that you have a persistent mass on the left side of your head, which has been present since childhood after an incident where you sustained a head injury. You also report experiencing headaches, particularly around the right eye and nose, along with a sensation of asymmetry in your eyebrow movements and occasional double vision. Additionally, you mention neck stiffness and swelling, which could be contributing to your symptoms.


Symptoms and Possible Causes
1. Head Mass: The mass you describe could be a variety of things, such as a benign cyst, a lipoma (a fatty tumor), or even a residual hematoma from the injury. While many head masses are benign, their presence can sometimes lead to discomfort or neurological symptoms, especially if they are pressing on surrounding structures.

2. Headaches: The headaches you experience, particularly around the right eye, could be tension-type headaches or migraines. Given your history of trauma, it’s also possible that the mass could be contributing to these headaches, especially if it is affecting the surrounding nerves or blood vessels.

3. Neurological Symptoms: The sensation of asymmetry in your eyebrow movement and the occurrence of double vision are concerning. These symptoms could indicate that the mass is affecting the cranial nerves responsible for facial movement and vision. This is particularly important to evaluate, as any neurological involvement requires prompt attention.

4. Neck Stiffness: The stiffness and swelling in your neck could be related to muscle tension, possibly exacerbated by poor posture or stress. However, if there is significant swelling, it may warrant further investigation to rule out any underlying conditions.


Recommended Actions
Given your symptoms and history, it is essential to seek a thorough evaluation. Here are the steps you should consider:
1. Consult a Neurologist: A neurologist specializes in disorders of the nervous system and can assess the impact of the head mass on your neurological function. They may perform a neurological examination to evaluate your symptoms further.

2. Imaging Studies: The neurologist may recommend imaging studies, such as an MRI or CT scan, to get a clearer picture of the mass and its relationship to surrounding structures. This can help determine whether the mass is causing any pressure on the brain or nerves.

3. Referral to a Neurosurgeon: If the imaging studies indicate that the mass is causing significant symptoms or if there is a concern about its nature, a referral to a neurosurgeon may be necessary. They can discuss the risks and benefits of surgical removal if indicated.

4. Physical Therapy: If neck stiffness is a significant issue, physical therapy may help alleviate some of the discomfort and improve your posture, which could, in turn, reduce headache frequency and intensity.

5. Monitoring Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any potential triggers. This information can be invaluable for your healthcare providers in diagnosing and managing your condition.


Conclusion
It is understandable to have concerns about the head mass and its potential implications for your health. While it may not be causing significant issues currently, the presence of neurological symptoms such as double vision and asymmetry in eyebrow movement warrants a thorough evaluation. Seeking the advice of a neurologist and potentially a neurosurgeon will provide you with the best course of action to address your concerns and improve your quality of life. Remember, it is essential to advocate for your health and ensure that all your symptoms are taken seriously by your healthcare providers.