Daily headaches and fatigue toward evening

[tjon788]

I am a 54 year old male who had endiscopic sinus surgery to remove polyps 1 year ago.  After the surgery I had continual headaches daily for 5 weeks which eventually led to a "Foggy Head" or "Brain freeze" type symptom.  One year later I continue to get the onset of a dull to medium headache every day between 5 and 8pm.  If I take Advil, It will provide some relief and I can at least function socially or otherwise.  In order to get any kink of restful sleep, I need to take either Advil, or Lorazepam.  Generally I will feel okay in the morning and the cycle starts again.  I have had CT scan  and all kinds of blood tests to no avail.  Have not had MRI.  I eat well and exercise vigorously 4-5 times a week.  I'e heard mentions of CSF leaks which could be slow and cause the onset of these symptoms later in the day.  Can any on relate or provide advice?  Thanks

Tjon

[tjon788]

Thank you for your response and sorry for the long period between posts.  It has now been over 15 months since my sinus surgery and the daily headache pattern continues.  I have seen a neurologist who has prescribed a number of medications to treat migraines including amnitriptylene, valproic acid, effexor etc.  He also did an MRI of the brain and all was normal.  I do not believe that my smptoms are that of a Migraine and am looking for other answers.  I've also tried acupuncture,  and massage therapy to no avail.  What is unique about my situation is that my symtons come on late in the day and are at there peak at about 8pm.  I am generally pretty normal during the day unless I have had a poor sleep.  I am at the point where I cannot get a good sleep without the help of Lorazepam and advil.  I should also mention that I have GERD and take Nexium daily.  Any further thoughts would be helpful.

[Dr Sharma]

Hello dear and welcome to the medhelp forum. Is there a reason for you to believe csf leaks; any investigation or intervention involving dural tap could be a possible cause for these headaches? Chronic migraines could be the cause but the headaches are one sided, severe, cause nausea or light sensitivity. Tension type headaches involve both the sides of head and can affect chronically. You need to be checked for hypertension, stress and anxiety. An MRI head and cervical spine is indicated to rule out any intracranial space occupying lesions or cervical degenerative disc disease. Consult a neurologist immediately. Management would be appropriate to the diagnosis. Wishing you all the best.