forehead swelling with severe headache?

I have a history of sinus infection and have had anteral windows done twice.  I recently began having very severe headaches around my forehead and behind my eyes.  However, a CT shows no active infection in my sinuses.  My symptoms are similar to migraine symptoms (severe headache, blurred vision, dizziness, nausea), except that my forehead is visibly swollen and VERY tender to the touch when the headache is bad.  Can a person have swelling of the forehead due to a migraine or due to a sinus condition other than active infection?  Or do you have any other feedback on what might be causing these headaches?  Thank you for your time.

[CCF Neuro[P] MD, RPS]

Dear Erika:

Sorry about your headaches.  Yes, one can see both mild edema and skin paraesthesias that occur with migraine.  Without being able to examine you it is difficult to give you an exact diagnosis.  But what your explaining is very compatible with a migraine.  The negative CT is also an indication that this is not due to a sinus infection.  There are other things that could give you these signs but they would have been evident by now.  You may want to check with your physician to make sure that there is no need for a sedimentation rate determination or other tests needed based on your medical history.

Sincerely,

CCF Neuro MD

[Erika]

Thank you for your time and for your prompt response to my question.  If anyone else has seen or had experience with similar headaches (severe pain/moderate swelling of the forehead with a migraine-type headache), please let me know, as my current doctor does not have any experience in this area.  Thanks again!

P.S. I also have some type of inflammatory arthritis (probable rheumatoid arthritis)-don't know whether that could be related or not.

[CCF Neuro[P] MD, RPS]

Dear Erika:

I wouldn't think that your RA is causing the swelling and paraesthesias.  We see this in a subpopulation of our migraine patients.  

CCF Neuro MD

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