Brief Answer: Get second opinion. Periodical examination, Scans Detailed Answer: Hello, I have gone through your query and understand your concern. You must show your scan reports and get second opinion a another Neurologist and Radiologist to rule out the possible causes like any vascular anomalies in base of brain. Because vascular anomalies in base of brain or other region may present as frequent headaches. If the opinion is said to be normal and there is no change in shadows and also no growth consistent with cancer or other diseases for last 5 to 6 years, then it is better to ignore now. But you need a periodical neurological examination atleast once in a year and MRI or CT scan every 3 to 5 years to monitor these unexplained shadows. As Ice Pick head aches are common in migraine patients. Just continue the Citalopram, it may reduce the frequency of headaches. But there is no proven cause for ice pick headaches. My advice is continue the Citalopram if every thing is normal. Hope this helps. Please write back for further queries. Wishing you good health.

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