2 CTs and 1 MRI and still no clue

[Denverdenmom]

Findings seem not to be indicative of constant pain and the sudden onset events. Worried re. small vessel disease – in terms of stroke and dementia issues.
CT w/o/c 12/08.  Constant headache on right side of head specifically right eye brow and cheek bone area and infrequent (perhaps 5 – 6 per year) sudden onset, excruciating stabbing pain onset late 07 2007.

12/08 CT w/o C:  “ thickening of rt frontal bone just to the rt of midline w central area of ground glass attenuation …  does have focal mass –effect on the right frontal lobe. 1.2 X 2.5 cm.”a) normal brain; b) right frontal bone lesion suspicious for fibrous dysplasia" .
9/09 CT w/o C -   4 mm hyperdense nodule, roof of 3rd ventricle; may rep. small colloid cyst,  hypodensities  inferior, posterior  basal ganglia … likely enlarged perivascular  spaces;  no evid. Of intracranial hem, abnormal extraaxial fluid, hydrocep, etc.  Focus of groundglass density of the rt frontal skull … represents a focus of fibrous dysplasia. . incidental..  mild cervical spondylosis on scout image.  

MRI  11/09 -  “few foci of T2 hyperintensity noted thru out the subcortal white matter frontal lobe consis. w sml vessel ischemic change.  “no ab enhncmnt ntd in brain. cereb. tonsils slightly low –lying. No hydrocep.
vertebral basilar & cavernous carotid arteries demonstrate signal void. Grad. Echo  - no evid. Of hem, images thu rt 8 norm. Impression: non-specific small vessel disease, no mass lesions

Pain is constant  and the sudden onset HA have become more frequently – two in last 30 days.  I am 5’7 weigh 108, been a quasi-vegetarian since about age 15.  I have high blood pressure (must be heredity) and for which I take lisinopril 30 mg a day – this was just increased from 20 mg last week. Just got thorough blood work up results back mostly normal or high end
Question:  
Is there something else that should or could  be explored here?

[Abhijeet Ghosh]

Dear Denverdenmom,
I can fully understand the pain you are going through.But there are too many findings in your scan reports but they are not at all contributing to the symptoms, which you are experiencing.I would still insist , that you should meet a neurologist because he needs to examine you and confirm the symptoms with the signs (signs can only be elicited by the examining doctor).The medication for  bloodpressure is good, and i am sure that it's not contributing to the present symptoms.So in these sort of cases, real time consultation becomes a must.Hence my advice would still be , to meet a neurologist.Once you meet him/her , you can discuss the medications given by him.Trust me, you would feel better.
Take care,
Regards.

[Denverdenmom]

My expectations of this "post a question to the expert forum" were far too high or unrealistic.  One thing, is the operative word here "earliest"? My internist who has ordered these tests is addressing these findings as "what else should we try to treat the pain?" Should we try the vicodin again for awhile? (rebounding) .. maybe a muscle relaxant?  migraine meds?  I am having to push for a referral to neurologist!  What a mess of a health care system.  I feel like a pharmacy blender and a hot potato.  No one is correlating.  This type of stuff makes people even sicker.

[Abhijeet Ghosh]

Dear Denverdenmom,
I can understand the stress you are going through.But these sort of radiological findings need to be perfectly co-related with the physical sign and symptoms.So i would suggest you to take earliest appointment with a good neurologist and consult him.This has to be dealt with proper observation.SO appointment with your doctor is must.
Please coordinate with the doctor.
Regards