What type of headache is this?

[Medavinci]

Does anyone experience headaches that start in the middle of the night, and are bad in the mornings....it hurts above my temples, my forhead, back of neck and my face (jaw, facebones).  Ironically, yesterday I was fine when I went to the ENT to check my sinuses.  He looked inside my nose with a pediatric scope and said they weren't infected but I had some fluid in the ethmoid sinuses.  I had a nosebleed on my left side, but the pain is a dull ache. I had taken some motrin before bed, but clearly it didn't help.

I have cervical stenosis of C-2-8, osteoarthritis....the headache is brutal.  I also have hypertension, but this doesn't feel like a hypertension headache....the weather is bad today, windy and is going to rain.  I notice my face hurts in rainy weather for some reason.

Thanks.

[Medavinci]

Thank you for the response.  I recently had an MRI of the brain and a cat scan of the brain as well as an MRI of the cervical spine.  The ct of the brain noted a linear calcification along the left tentorium which is non-specific (this is the side of the head that the headaches always are when thye are this bad - I should have included that in my original post - it is a crushing/throbbing pain above the left ear into the face and teeth with numbness in the left jaw line). It said there there was patchy opacification of the frontal portion of the ethmoid air cells extending into the lower aspect of the left frontal sinus.  I have been getting these huge cysts in the orbit of the eye that fill with fluid (i look like a prize fighter when it happens and it can happen anytime anywhere; the eye dr said it wasn't an eye problem, maybe an allergy; however when i looked at the picture of the ethmoid sinuses, it is exactly there). The sinus dr said he did not see an infection, and if there is fluid there, the only way to determine if anything was seriously wrong was through surgery which he didn't advise.  He told me to just flush the sinuses with saline and use rhinocort. I did the rhinocort last night and the nosebleed came (it didn't last long).

I have uncontrolled high blood pressure as well (it started in june out of nowhere, and i lost 30lbs as well which is bizarre since i've been trying to lose weight for 10 years since menopause started).  I tried 3 different bp meds at different times: norvasc 2.5mg, plendil 25mg and aldactone 12.5mg - and all gave me the exact same type of headache I have gotten these past 2 times, only i had vomiting with the bp meds - the headaches came on 1-2 hrs after taking it and elevated my bp to 250/135 (my normal since I was diagnosed with hypertension has been about 150's/100's - with these headaches of late it has jumped to 170's-180's.  It is so frightening.  I will try atenolol next week at a very minute dosage.

The MRI of the brain showed nonspecific white matter areas of increased signal intensity seen in the cerebral hemisphere bilaterally; at least a dozen bilateral areas of increased signal intensity in the subcortical white matter as well as the periventricular and deep white matters. This is a nonspecific finding which can be related to microvascular ischemic change.  This additionally is found in sequela of prior infection or injury as wellas demyelinating disease although this does not have the typcial appear ance for demyelinating lesions and does not show decreased signal intensity on T1 weighted images.  There is an area of increased signal intensity demonstrated on T1 sagittal imaging in the region of the falx which likely represents a small focal area of fat (I have no clue what this means as it wasn't explained to me); no evidence of abnormal blood product; and sinus mucosal thickening in the left frontal sinus as welll as the ethmoid sinuses bilaterally, right greater than left. Also, subtle mucosal thickening in the left maxillary sinus.  Review of diffusion weighted images shows no evidence of acute ischemic change.

With the cervical spine, I wake up with severe neck and muscle pain in the back of the neck and my shoulders are like cement.  I also have rib pain on the left side that has been here since june which has not been investigated.  I'm basically a mess! The MRI showed degenerative changes with erver vertebrae from C-3-C-7 with significant foraminal and central canal stenosis of C5-6, C6-7.

My frustration is that the 3 times I have gotten this horrifying headache on the left side of the head with pain into the left side of the face and teeth, that I went to the dentist to see if a prior root canal had resurrected, and there was some scar tissue.  The dentist pressed on the left side of the head where the pain was and said it could be trigeminal neuralgia (at this point, I think everyone is guessing).  But the right frontal pain and eye pain and neck pain divert their diagnosis.  

The neurologist phoned me back tonight and I was so disoriented that I couldn't convey that I can't drive or do anything with this kind of pain - no bending down, no coughing (heaven forbid) and I have to hold my head if I need to walk around.  I asked if it was dangerous and he just said no.  He said he could treat it, but didn't say "how".  I got off the phone crying as I can't live this way.  It is the worst headache imaginable.  With the numbness in the left side of the jawline, I was thinking it was a stroke, but I didnt mention it to him and he's off-duty for the weekend.  If this pain continues until tomorrow, I will go to the ER as my neck and shoulder pain is exacerbated. I took motrin 400mg last night and I woke up with the wretched pain. I took another this morning (and motrin elevates bp as does the headache) and then took a .25mg xanax which I usually take at night. I also noticed each time the headaches have come is when the weather is windy and rainy.  

Sorry for the long post, and thank you for your response.

[Dr Rajgopal]

Hi,
Your symptoms suggest of a sinus headache. The headache starts at midnight and becomes worse in the mornings due to draining of fluid in the sinuses. Since your ENT doctor confirmed the presence of fluid in the sinuses, you must start taking treatment for it. Please go for CT scan of the head and consult the ENT specialist again for treatment. Hope this helps you. Take care and regards!