Sinus versus migraine headaches

How can we distinguish between a true sinus headache versus a migraine headache?
This is a major diagnostic dilemma which has been a concern and interest of mine for many decades. The recent medical literature is beginning to finally address this common long-term dilemma.
A recent review in the International Forum of Allergy and Rhinology has confirmed the approach we have followed. Treatment will follow a precise and targeted fashion. The work up should include not only a history, careful physical examination, and nasal endoscopy, but also CT scans with high suspicion for a diagnosis of migraine headache. In the absence of finding sinusitis. attention towards a neurological cause should be pursued.

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