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HEADACHE on RIGHT SIDE from eye, up the head to back of the head. Sinus...
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HEADACHE on RIGHT SIDE from eye, up the head to back of the head. Sinus related?

HEADACHE on the RIGHT SIDE starting from the Eye running straight up the head, along a thin line path, to the back of the head.   I am posting this for my father-in-law in India. He is 77 years old and is frequently getting a headache on the right side of the head for the past 6 months. Though the  pain is almost always along a thin line on the right side, occasionally there is mild spread on both sides of the head.  Sometimes there is a 'slightly gripped' feeling. Coughing increases the pain; sometimes cough triggers/starts the headache.  But the pain eases off on Painkiller tablets.

When the headache started about 6 months ago (Jan 2010), it was thought to be toothache and the Dentist did 3 root canals. But the headache did not go away.  Nerve pain was suspected; Neurologist was consulted; Brain scan, EEG etc. were ok  and no problem was found. Migraine seems to have been ruled out.   Now (July 2010) after CT scans, the ENT specialist recommends surgery based on the diagnosis: "Nasal Septum Mild Deviation to the left side Sinus with a Bony SPUR & Left Maxillary Antral Polyp".   Blood tests & Echo are OK.  Advice is to take a 64 slice Cardio scan, to prepare for surgery.
Further Details of the LEFT SINUS on the Scan:
1.Soft tissue noted on LEFT frontal Sinus;
2.Sinus is blocked on the left side;
3. 1.Soft tissue density is noted in the LEFT Maxillary Antrum;
2.Maxillary Ostium & Infundibulum are widened on the left side.
3.Minimum mucosal thickening noted in the Maxillary Antrum.

ENT Doctor wants to do Surgical Cleaning of Left Sinus.

Other medical conditions:
1) Mild Asthma; taking an AntiHistamine tablet daily&use COMBITIDE 250 Puff once or twice a day.
2) Type 2 Diabetes is under control with Tablets;
3) BP is @ 150/80 with tablets.
4) Pacemaker implanted 4 years ago (Feb 2006) to address arrhythmia; that was 'discovered' when the symptom of constant hick-ups was being diagnosed (as an aside...even with pacemaker, the hickups returned briefly.. and do return on-and-off.. but it is not severe and not constant).

Big decision now is whether to go ahead with the Sinus surgery or not. Additional questions are:
1)Could blockage/BonySpur/polyp on left sinus cause right side headache?
2)Or Would these be 2 unrelated issues?
3)If these are unrelated, what could be the cause for the headache ? & what is the treatment?
4)Even if these are unrelated, would the “Surgical Cleaning of Left Sinus” something that he should go ahead with? What are the pros&cons?
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Hi, Thank you for your question. For persistent headaches and other symptoms, possibilities like migrainous, cluster, tension, sinusitis and refractive errors that need to be evaluated thoroughly with the help of a neurologist here. Migraine like headache can be throbbing, one sided of face & head and preceded by aura (starts with blurred vision). Cluster headache may appear as burning, explosive in nature and tear appears from eyes. Tension headache originates with stress and anxiety disorder. Please arrange an appointment with a neurologist right away who will evaluate the further underlying disorders by clinically examine you & ordering MRI or CT scan here that may be the main reasons of your headache attacks & other symptoms and can provide you an appropriate treatment. Hope this information proves helpful to you. Take Care & Regards!!!

Thanks for the reply Dr Srivastava.    
Neurologist was consulted to begin with for this RIGHT side Headache; after EEg etc. he referred to Dentist (who root canal procedures); following that to ENT specialist, who  found LEFT side sinus blockage/polyp/BonySpur..from CT scan. and recommend SinusSurgery right away. Pre-op steps are proceeding now (Cardio scan , meet with Cardiologist etc).      

Do you recommend an evaluation (re-evaluation) by the Neurologit BEFORE the SinusSurgery? Or should he go ahead with SInus Surgery and then followup with Neurologist?

Sinus surgery was done in August and seem to have reduced the sinus pressure. However the HEADACHE on RIGHT side is still there.  Coughing makes it it was earlier (and often triggers the pain).  

What could be the cause for this persistent headache? Any inflammation ?    If so wouldn't that have been seen on the scans?

To recap... the Neurologist, Dentist and ENT surgeon have all been consulted for this headache. Scans, root canals & sinus surgery have been done, during the past 8 months (since Jan 2010); optic nerve was also checked out to be ok.  Is there anything else that should be checked? Thanks in advance for your advise.
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