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Top Right Side Pain. CT Says Mild Mucossal Thickening Right Side Sphenoid Air Cell. Treatment ?

Posted on Thu, 4 Oct 2012

Question: Hi,
My wife is having top right side pain , after CT SCAN it is mentioned that Mild mucossal thicking right side sphenoid air cell. Otherwise no significant mucosal thinkcing of fluid.

She was in medication - 'Augmentin 875-125 mg 1 tablet for 10days '. we have completed 15 days ago.
Nothing worked out. still she is having the same pain.
Please let me know your feedback about what would be our next step and what medications you are going precribe.
Uploaded the CT SCAN report and Medication details.
Regards
XXXXXXX

Answered by Dr. Shiva Kumar R (10 hours later)

Hello

Thanks for the query

Regarding the hemicranial headache (right sided) I personally feel probably she is suffering from vascular headache, probably migraine. Other causes for hemicranial headache are sinusitis, dental caries and temporal arteritis. Considering the age and the imaging findings I personally feel migraine as the cause of headache rather than sinusitis.

So I personally request you to provide additional details of headache like:
1. visual symptoms at or before onset of headache
2. Associated nausea, vomiting or tinnitus in the ears
3. Duration and frequency of headache
4. Presence of photo and phonophobia
5. Medications used for headache in the past.

With these details I will be able to suggest the possible cause of headache and further course of action.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shiva Kumar R (38 hours later)

Hi,

There is no issue with the visual and she can view clearly.

There is no vomiting too.

Duration of headache , it is high in the morning and goes low and up again.

'Augmentin 875-125 mg 1 tablet for 10days '. we have completed 15 days ago.

she does not have headache in the forehead, it is at the top of the head, right side which is paining much .

Request you provide what shall i do, I am terribly upset with this issue.

You will god for my part, if there would be some remedy from your end.

Thanks in advance.

Regards
XXXXXXX

Answered by Dr. Shiva Kumar R (8 hours later)

Hello

Thanks for the query

From the description it looks like she is suffering from daily headache, probably a combination of migraine and tension type headache. Other causes which needs to be considered are hypertensive headache and refractive errors (visual problems).

So I personally advise you to XXXXXXX a Neurologist for a good physical examination and consultation. You need to check her eye sight to exclude refractive errors. If the blood pressure is high she needs treatment for control of Hypertension. She will need medications for both migraine and tension type headache. Commonly used medications are a combination of flunarizine, beta blockers and tricyclic antidepressant like Amitriptyline.

I am sorry you are dealing with this frustrating concern and I hope you can find yourself in better health soon with the help of your Neurologist. You need to be on medications to prevent headache becoming more chronic in the future.

Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar