Brief Answer:
consultation

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. I have read your previous and this question. The MRI report is suggestive of some focal lesion in medulla oblongata (Brainstem). According to radiologist, it is either ischemia or inactive demyelination. Both conditions are benign and usually non-progressive. Hypoplasia of sigmoid sinus is incidental finding.

But ask your radiologist whether there is any doubt of brain tumour like Glioma? If yes, get MRS of lesion done to rule it out. Treatment of glioma at this site is mainly chemo-radiotherapy, while ischemia and demyelination are dealt with further investigation and either few medication or no treatment at all.

You must consult ENT doctor for maxillary sinus polyp or retention cyst. It is usually due to chronic sinusitis. Sinusitis is a very common cause of headache and if deviated nasal septum is present with it, it very frequently gives rise to headache.


Now coming to other cause - Tumor can cause headache, but ischemia or demyelination usually do not cause headache.

If no tumor, your headache could be "stress headcahe" or less likely due to this focal lesion. It is unlikely to be "Migraine" as migraine is
: One side headache
: Auro symptoms before pain like bad smell,bad taste etc.
: Headache occurs with vomiting, visual blurring, redness, tearing in eyes.
: It is seasonal, even occurs after eating certain food like Cheese/chocolate.

It can be stress or tension headache if it
: Occurs for long duration
: Heaviness of head
: Band like sensation around forehead, dull pain
: Pain remains before and after sleep. Less effects of medication in relieving pain
: Pain increases by working, watching TV/laptop, taking stress
: There is generalised fatigue, weakness, stress.

If your symptoms are such that it could be Tension/Stress headache. Do let me know about your radiologist opinion about tumour, ENT consultation and similarity between your headache and features of tension headache. I will guid you further. No need to worry. With proper diagnosis, every headache can be managed.

Hope it will help you. Thanks. Take care.

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Brief Answer:
Consultation

Detailed Answer:
Hi XXXX, welcome back.

As your symptoms are almost same as that of Stress/Tension headache, I will give you few tips to control it. This headache is one of the most common type of headache and almost every person suffers from it once a while. You should

: Avoid mental stress completely. Do not think too much about every day problems. Discuss them with your friends or family.
: Avoid dehydration and extreme exertion. It increases pain.
: Avoid bright light, late night TV/laptop, reading in dim light, too much reading in a day (like more than 3-4hours in a stretch).
: If your work is totally computer/laptop based, you need to use glare protecting glasses. Use adequate light, not too bright or dim. Always wear your glasses if you have one.
: Avoid direct sunlight on eyes. Use sunglasses.
: Regularly check your eyes number to rule out any increase in refractive error.
: Do Yoga or meditation to remain calm
: Head and neck massage will relieve pain.
: You can take Tab Paracetamol 500 mg to relieve pain after proper prescription. Avoid too much drug use. If uncontrolled pain, you may take Duloxetine/Amitrityline after proper prescription.
: Maintain 8-9 hours sleep routine.
: Caffeinated drinks help in relieving pain. You can have coffee or tea while having pain.

The stress/Tension headache ethology is not clear, most common reason is thought to be tension and eye muscle spasm. Above measures will help you in controlling both.

Even after this, if you still have pain, get BP and eye examination to rule out hypertension and eye disease. If you need any help, do let me know. Thanks. Take care.

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