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Dr. Mark
Dr. Mark, Neurologist (MD)
Category: Neurology
Satisfied Customers: 1985
Experience:  Neurosurgeon - Brain, spine, and peripheral nerve surgery
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I am a 33 year old female who is most part healthy.

Customer Question

Hello I am a 33 year old female who is for the most part healthy. For about the past 2 1/2 years I have been experiencing headaches, head pressure, dizziness. Occasionally I get a fluid-ish/clogged feeling in my ears. I have seen two ENTs and one Neurologist. The ENT ordered a CT scan last year and there were a few small polyps? (spelling) and slight nasal turbinates. Nothing to cause the type of pain and where I am experiencing it. The head pain is usually above and behind my ears. I get the throbbing, pulsating kind of headaches. Occasioanlyl I feel them of my eyebrows and top of my head. So that lead me to see a neurologist.... after numerous "migraine medications" he finally ordered an MRI without contrast. Results were normal.
1) mild mucus thickening in the paranasal sinuses. Mastoid aircells well aerated.
2) "Several small foci of increased T2 FLAIR signal in subcortical white matter tracts in the cerebral hem....... This is a nonspecific pattern and could be associated with migraine headache. The distribution would be somewhat unusual for the initial presence of a demyelinating disease but that possibility cannot be completely excluded. If symptoms persist, a follow up imaging may be of benefit in establishing stability.
With all of that said, my neurologist did not seem too concerned about those "small white foci". But instead has suggested to do botox injections for the headaches. I am debating on doing this. I honestly do not know if my issues are more for an ENT to further explore or a Neurologist. I just had allergy testing done to rule out any allergies and tested negative. The allergy doc did point out that both nostrils were 80% blocked. I have come to accept this as a normal way of life. I am used to it.
I will note in conclusion that I often get sinus infections. My nose hardly runs and I feel like the musus and fluid remains "stuck in my sinuses" whenever I get a cold. This is when my headache and head pressure are at the absolute worst!!!!!! In casual conversation with the allergy doc I mentioned to her ofcourse the results of my MRI. She (the allergy doc) is not convinved that I have classic migraine at all and feels my headache issues are ENT related and should persue a second ENT opinion. While I agree because I do not get that aura with my headaches (common in migraines)and the location of my head pain (ears, center back of head). But after getting the MRI results saying those white foci could be "related to migraine head aches" I don't know what to think. I just want to feel better. Could sinus pressure/headache cause the foci/scar tissue that appeared on the MRI report? Thank you for taking the time to read my story.
Submitted: 1 year ago.
Category: Neurology
Customer: replied 1 year ago.
I also wanted to add that the neurologist ordered blood work looking for vasculitis and other auto immune disorders. Blood work came back normal.
Expert:  Dr. David replied 1 year ago.
This is Dr. David
have you tried a course of antibiotics?
you could have a common bacterial sinus infection which can cause bad headaches