sinus or tumor

[tania again, add to question]

On 10/16, I emailed you about headaches I was having.  I am still having the headaches.  They are daily.  I am not being awakened at night nor do I notice they are extremely bad in the a.m.  What I am noticing is that they are bad during the day. It is lots of intense pressure-around the eyes, the forehead, the nose bridge.  Sometimes, I have headaches on the top of my head or the tempal area as well.  I also get dizzy.  My right eye is extremely dry at times also. One doc suggested Cipro for a month, which I have taken and found no relief. She found I had a sinus infection.  Now, my drainage is clear, and I have no fever.  However, I have suffered chronic allergies and sinusitis forever. My prior CT, in June, showed minor blockage in two sinus cavities (I can't rember which--I think the E-one was one)However, I was never treated for the minor blockage.  The ENT specialist told me mild was nothing to worry about. I usually can breathe out of one nostril or the other, but not always both--sometimes I can breathe out of both, but usually, the right one is plugged and I get very little or no air at all.   I am scheduled for a MRI next week. I am terrified I have brain tumor symptoms, even though I have sinus problems.  My very brief (shin to calf exam, heel to toe,  and eye exam at doc was normal)
Does this sound like sinus blockage?  Brain Tumor?  Having run the course of antibiotics and no relief scares me. Can plugged sinus cause my problems. What do you suggest?

[mr t]

I recently had a MRI AND CT of the sinues and brain.  My neurologist says i have hardening of the arteries of the brain, but for my age is usual.  I have no tumors, no anyrisms seen, i do have a blockage behind my right eye in my sinus cavity.  My ENT has given me nasal spray and a predisone tablet to take to see if this will reduce the size of the blockage.  My scalp tingles and sometimes hurts so bad i can not brush my hair or wear a cap. I have severe headaches, my neurologist says these are cluster migranes started and has given me imtrex, and they do seem to help.  My ENT says if i can no longer live with the pressure behind my right eye i can have a simple surgery to remove this blockage.  I recently had a abscess tooth and the infection had affected the right side of my head with the headaches started, i have 3 more teeth to be pulled and have been going back and forth with the insurance co and the oral surgeon office manager since August to get this wisdom tooth and two in front of it pulled, any help that way i would appreciate it.  I also have CAD, which now is controlled with medicine and diet, exercise and watch the cholestrol, i have a excellant cardilogist.
Can anyone tell me about the sinus surgery and what the danger is of this ?

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

Still could represent atypical migraines or daily tension headaches, especially if the exam was normal (though you do say that it was a brief exam.) Sinus headache becomes less likely if the ENT says everything looks "mild" and you've already done the course of antibiotics without any change in symptoms. Also, if the CT was of your brain and not just sinuses, then that should be somewhat reassuring that there's probably no tumor. A normal MRI should help allay your fears and if all routine labs and testing are normal, then consider  seeking headache treatment from a neurologist. There are many different medications that can help with your symptoms. Indomethacin as well as other NSAIDS are a good start. If they're atypical migraines, zomig or imitrex can be helpful. ANd if it's a severe nearly constant headache, you may need more aggressive abortive therapy with oral steroids, IV magnesium, IV depakote, or even botox injections. GOod luck.