Sinusitis is a condition consisting of inflammationof the paranasal sinuses, which may or may not be as aresult of infection,from bacterial,fungal, viral, allergic or autoimmuneissues. Newer classifications of sinusitis refer to it as rhinosinusitis, taking into accountthe thought that inflammation of the sinuses cannot occur without someinflammation of the noseas well (rhinitis)
Sinus headache Headache/facial pain or pressure of a dull, constant, oraching sort over the affected sinuses can be seen with either acute or chronicstages of sinusitis. This pain is typically localized to the involved sinus andmay worsen when the affected person bends over or when in the supine position. Pain often starts on one side of the head andprogresses to both sides. Acute and chronic sinusitis may be accompanied by thickpurulent nasal discharge (usually green in colour and with or without blood)and localized headache (toothache) are present and it is these symptoms that candifferentiate sinus related (or rhinogenic) headache from other headachephenomena such as tension headache and migraine headache. Infection of the eyesocket is possible which may result in the loss of sight, accompanied withfever and severe illness. Another possible complication is the infection of thebones (osteomyelitis) of theforehead and other facial bones - Pott's puffy tumor.
Recent studiessuggest that up to 90% of "sinus headaches" are actually migraines.The confusion occurs in part because migraine involves activation of the trigeminalnerves which innervate both the sinus region but also the meningeswhich surround the brain. As a result, direct determination of the site of painorigination can be confused on a cortical level. Additionally, nasal congestionis a not uncommon result of migraine headaches, due to the autonomic nervousstimulation that can also result in tearing (lacrimation)and a runny nose (rhinorrhea). A study found that patients with "sinusheadache" respond to triptan migraine medications and statedissatisfaction with their treatment when they are treated with decongestantsor antibiotics.
Due to the proximity of the brain to the sinuses, the most dangerouscomplication of sinusitis, particularly frontal and sphenoid sinusitis, is thespread of infection through the bones or by blood vessels by anaerobic bacteriato the brain. Abscesses,meningitis,and other life-threatening conditions may result. In extreme cases the patientmay experience mild personality changes,headache, altered consciousness, visual problems, and, finally, seizures, coma,and possibly death.