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Head injury, headache, diagnosed as migraine, Imitrex not effective. Am I right in engaging an ENT?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10351 Questions
12 years ago I awoke from a dream by literally slamming my face into the bedside table. My face was literally covered with blood within seconds. After washing my face , I saw a gash of about half an inch with a slight indent at the inner corner on my left eyebrow. Because of the significant pain and the profuse bleeding I drove myself to the ER and saw the waiting room over flowing and decided to drive right back home. The next day I went to GP and he put 2 butterfly strips on the wound. About 2 years later, I began to have severe headaches, first diagnosed as chronic sinusitis, and later migraine without XXXXXXX For the past 7 years, I get 3 to 4 migraines per week which are mostly controlled if I take Imitrex (100) in time. I take approximately 160 Imitrex per year. In the past two months the severity of my headaches as increased, and Imitrex is not an effective treatment. Because there is always so much pressure in my face when the headache is present it led me to wonder if perhaps this injury might have caused bone damage which is at the root of my headaches . I have scheduled an ENT appointment, but because based on facial structure diagrams , I am pretty sure the bone involved is the glabella, do ou the I am engaging the right specialist?
Posted Wed, 25 Apr 2012 in Head Injuries
Answered by Dr. Praveen Tayal 3 hours later
Thanks for posting your query.
An injury of face 12 years ago may be responsible for migraine headaches if you suffered an XXXXXXX injury at that time. For proper diagnosis and treatment, a neurologist is the best person to consult. An ENT specialist is not likely to help you much.
I encourage to fix an appointment with your neurologist for further management.
I hope this answers your query effectively.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.

Above answer was peer-reviewed by
Follow-up: Head injury, headache, diagnosed as migraine, Imitrex not effective. Am I right in engaging an ENT? 3 hours later
Thank you for your answer. I have been under the treatment of a neurologist for 9 years. Frankly, I only recently recalled the incident 12 years ago, and I will mention it to him. It is very difficult to accept the level of severity and frequency of my headaches as basically not having an identifiable cause, and the hope of a cure. They have defined ny life. Family vacations have been ruined, I have been in available to my only daughter for once in a lifetime events because I had a debilitating headache.
It has been profoundly frustrating to find my own way through treatment options. That is why I asked you which type of specialist to engage. I have been to many! Several years back, The pain was so severe in my head and on the right side of my face once for several months, I was certain I had a cracked tooth. In short, I had two root canals, no relief, eventually two back molars were extracted and I now have implants. Throughout that long and extraordinarily expensive journey, the right side of my face felt like something was broken. After all the work was complete, the headaches continued. Would the neuro be looking for, and could he see a deviated septum or nasal spur on head scans he ordered? He has never mentioned anything about my sinuses. Is there something I should tell him to ensure he has looked at my sinuses?
Answered by Dr. Praveen Tayal 2 hours later

Thanks for writing again.

Headaches are sometimes debilitating and considerably affect the quality of life.

In the brain scans, the deviated septum can be identified. You can ask your neurologist to rule out this as a possible cause.

Having a second opinion from an ENT specialist will also be helpful.
Do not worry. You will be in a better health in future with the help of your neurologist.

Hope my answer is helpful. Please accept my answer in case you do not have further queries.
Wishing you a trouble free early recovery.
Dr. Praveen Tayal.

Above answer was peer-reviewed by
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