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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Headache ?

I am 28 yrs old. During my sophmore year of highschool I crushed my forehead and sinus cavity. Four metal plates were put in during surgery. I have recently been getting very severe headaches at the exact location of injury, above my left eye. My sinus has a small drip, but I m not congested. I breath freely through my nose with no problem. I have a very high tolerance to pain and I ve never experienced a headache this severe.
Tue, 17 Nov 2020
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Internal Medicine Specialist 's  Response
Hi,

Your symptoms are unfortunately not uncommon with facial bone fracture that have been repaired. As the bones heal and scar tissue forms, the nerves that supply sensation to the facial do oftentimes become involved. I realize that the surgery was probably about 13 years ago or so, but as your get older the bones themselves "remodel" and adjust growth and size which often will causes irritation to the nerves that overlay them. Also, it is possible, even at the age of 28, that you are developing some mild arthritis at the site of fracture. Many people report chronic pain at prior fracture site years or decades after the bones have healed.

The supra-orbital nerve, which runs directly above your left eye is a frequent cause for frontal headaches, I can imagine that the degree of scar tissue at this site is considerable and likely is causing some compression of the nerve. This very well may be amenable to treatment by a neurologist even if it is as simple as injecting a steroid solution into the area. Please consider this as a possible option, it generally works well in my experience. The other sources of pain and discomfort in the face do really pose some problems, there is not really much intervention beyond medication that may help. Neuropathic medications like, Cymbalta, Amitriptyline, or Gabapentin would likely be of benefit and it again may be worth discussing with a neurologist.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. David Girardi, Internal Medicine Specialist
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What Causes Severe Headache ?

Hi, Your symptoms are unfortunately not uncommon with facial bone fracture that have been repaired. As the bones heal and scar tissue forms, the nerves that supply sensation to the facial do oftentimes become involved. I realize that the surgery was probably about 13 years ago or so, but as your get older the bones themselves remodel and adjust growth and size which often will causes irritation to the nerves that overlay them. Also, it is possible, even at the age of 28, that you are developing some mild arthritis at the site of fracture. Many people report chronic pain at prior fracture site years or decades after the bones have healed. The supra-orbital nerve, which runs directly above your left eye is a frequent cause for frontal headaches, I can imagine that the degree of scar tissue at this site is considerable and likely is causing some compression of the nerve. This very well may be amenable to treatment by a neurologist even if it is as simple as injecting a steroid solution into the area. Please consider this as a possible option, it generally works well in my experience. The other sources of pain and discomfort in the face do really pose some problems, there is not really much intervention beyond medication that may help. Neuropathic medications like, Cymbalta, Amitriptyline, or Gabapentin would likely be of benefit and it again may be worth discussing with a neurologist. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. David Girardi, Internal Medicine Specialist