sinus headaches

[Marian__0]

   I am a 60 year old female in general good health. For the last couple of years I have been dianosed with chronic sinusitis. I had 2 surgeries a couple of years ago, due to the first one not being sucessful.Daily I take claritin 10mg. accolate 20mg and premaarin .625mg. I am in the last week of taking augmentin 500 mg 2 per day. My ey and dental exams are normal I have no adnormal drainage and can breath through my nose with no problems. I had a cat scan on Jan 28, which was fairly normal except for a few very slight congested areas in the sphenoid area. Now I have sharp constant pain in the sphenoid sinus  area which goes around to the left area behind the ear. It is much worst if possible when I bend, cough or sneeze espically in the temple area, I have trouble moving my head in any quick movement as it causes pain and pressur, Any help would be greatly received. Many Thanks/  Marian
Dear Marian:
Sorry to hear about your headache.  Without seeing the CT scan and doing a good physical examination, it is difficult to tell you what to do or give you an accurate diagnosis.  I think what you need to rule out is the possibility of temporal arteritis.  If your sedimentation rate is normal then it sounds like you have what we call mixed headache.  You have features of migraine and exertional headache but not all the features of either.  I would speak to your neurologist about proper medication.  We would likely start a medication called elavil, but different headache specialist have different medications that they like.  Best of luck.
Sincerely,
CCF Neuro[P] MD