Author: Luke O’Neill / Editor: Stephen Sheridan / Codes: / Published: 21/11/2025
A 46-year-old male self-presents to the Emergency Department (ED) with 3 months refractory headache, subacute forehead swelling (unknown duration) with acute periorbital oedema.
He has remarked nose blowing would magnify the pain, accompanied by blood and thick green mucous.
A GP phone consultant 2 months prior advised regular analgesia and sumatriptan. The patients pain was refractory to these, continuing only regular paracetamol. A systematic review revealed no preceding trauma nor ocular or neurological symptoms.
On examination, the patient is alert with no focal neurological signs. There is a tender swelling located mid-brow; 3x3cm. Bilateral periorbital oedema is noted below the eyes. Oscopic and dental exams are unremarkable. Extending the examination, there is no abdominal features or organomegaly.
The patient is a heavy smoker but reports no other medical history.
