Need opinion

[Dr. Bob]

For the last two months I have had, what I call "positional head pain". Bending over, coughing, sneezing, straining with a bowel movement creats a very strong head pain...mostly temporal (both sides) and sometimes the top of the head. They last from a few seconds to several minutes, with some residual pain. I am a 72 Y.O. male in good health, although for the past 10 years I have been taking  5mg Norvasc and 20 mg Zocor.
BP: 132/78
MRI: "no evidence of acute intracranial process"
Sed rate: 17
Cholesterol: 160 (HDL 59 and LDL 89)
CBC: Within normal ranges.
I have been advised to wait to see what happens.

I need your opinions, if possible.

[Dr. Bob]

It is very heart warming to receive an answer from the Clinic, but he (she) has said that "I would have to examine you" before coming up with a possible opinion. The problem is...who is he (or she)and how does one get in touch with him (or her)? Or, as an alternative, I guess an appointment at the Cleveland Clinic without an M.D.'s name may be the way to go.

[CCF-Neuro-M.D.-CS]

There is a type of head caused by exertion, and this is a possibility. The MRI has excluded structural lesions, and if it was done with contrast has also excluded disorders affecting the lining of the brain. Occasionally people can have spontaneous leaks of the lining of the brain and have headaches similar to yours. A contrasted MRI would help to exclude this, but not completly exclude this. The other thing to ask your doctors about is sinus problems. Occasionally this can present with intermittent headaches. Without examining you and talking with you I can not make specific recommendations. Good luck.