ENT service

Headaches

Headaches can be caused by sinusitis, vision problems, vascular headaches etc.

A good history taking and clinical examination is a must to get to the cause of the headaches. The commonest cause of headaches is sinus infections. That’s why, depending on the history, certain tests may be required to confirm the diagnosis or to rule out a possible cause. The commonest test required may be a DNE or Diagnostic Nasal Endoscopy. In this, a small telescope is inserted into the nose after spraying the nose with a mild local anesthetic. This test shows the ventilation of the sinuses and the structures inside the nose like the nasal septum and turbinates, which also play an important role in the functioning of the nose.

DNE tells the clinician whether the sinus drainage and ventilation pathways are blocked and whether the patient is suffering from sinusitis. It also shows whether the blockages can be corrected by medication or if any surgical procedure like Balloon Sinuplasty or Endoscopic Sinus Surgery (ESS or FESS) may be required.

An eye doctor may also be consulted to rule out a visual cause for the headaches. An undiagnosed refraction error or increased pressure of the fluid inside the eyeball are some of the causes.

Undiagnosed high blood pressure may also be a cause of headaches

Vascular headaches like a migraine can also be suspected and a trial of medication may help in confirming the diagnosis. An MRI scan of the brain or sinuses may be asked for.

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