Right-Sided Occipital Headache and Dizziness: Causes and Solutions

Right-sided occipital headache with dizziness?

Hello Doctor: I have been experiencing pain on the right side of my occipital region when lightly pressed for several years.
I had a car accident when I was younger, which resulted in a concussion in the back of my head.
Until three months ago, I would experience intermittent pain without any pressure.
I consulted a doctor, underwent an EEG and blood tests, and was told there were no issues.
However, there has been no improvement since then.
Just yesterday, on July 7th, while I was buying breakfast, I suddenly felt a sharp pain in my head, followed by dizziness, and everything went black.
I fainted and was only awakened by the shop owner.
What should I do? Thank you, Doctor, do you have any suggestions?

Xiao Dong, 30~39 year old female. Ask Date: 2016/07/08

Dr. Gao Chunde reply Neurology

If it were previous symptoms along with the examination results, a general physician would typically consider just monitoring the situation.
However, the pain, dizziness, and fainting that occurred this time, as well as any potential brief loss of consciousness, definitely require a doctor's evaluation for further investigation into the underlying causes.

Reply Date: 2016/07/08

More Info

It sounds like you're experiencing a complex set of symptoms that could be related to several underlying issues. Given your history of right-sided occipital headaches, dizziness, and a previous head injury from a car accident, it's crucial to approach this situation with care and thoroughness.

Possible Causes
1. Post-Traumatic Headaches: After a head injury, some individuals may develop chronic headaches that can manifest as tension-type headaches or migraines. These headaches can be exacerbated by stress, fatigue, or changes in posture.

2. Cervicogenic Headaches: These headaches originate from issues in the cervical spine (neck) and can cause pain that radiates to the occipital region. Given your history of a car accident, it's possible that there may be underlying neck issues contributing to your headaches.

3. Migraine: If your headaches are unilateral (one-sided) and accompanied by symptoms like dizziness, nausea, or sensitivity to light and sound, they could be migraines. Migraines can sometimes cause dizziness or vertigo, especially if they are severe.

4. Tension-Type Headaches: These are characterized by a dull, aching sensation and can be triggered by stress, anxiety, or poor posture. They can also cause discomfort in the occipital region.

5. Vascular Issues: Conditions such as migraines or even more serious issues like a transient ischemic attack (TIA) or stroke can present with sudden headaches and dizziness. Given your recent episode of fainting, this is a serious consideration.

Recommendations
1. Seek Immediate Medical Attention: Given that you experienced a sudden headache followed by dizziness and fainting, it is crucial to seek medical attention immediately. This could indicate a serious condition that requires prompt evaluation.

2. Neurological Evaluation: Since you have a history of headaches and a recent fainting episode, a thorough neurological evaluation is warranted. This may include imaging studies such as an MRI or CT scan to rule out any structural issues in the brain or cervical spine.

3. Monitor Symptoms: Keep a detailed diary of your headaches, noting the frequency, duration, intensity, and any associated symptoms (like dizziness, nausea, or visual disturbances). This information can be invaluable for your healthcare provider in diagnosing your condition.

4. Lifestyle Modifications: Consider lifestyle changes that may help alleviate your symptoms. This includes maintaining good hydration, managing stress through relaxation techniques (like yoga or meditation), and ensuring you get adequate sleep.

5. Physical Therapy: If your headaches are related to neck issues, physical therapy may be beneficial. A physical therapist can help you with exercises to strengthen the neck muscles and improve posture, which may alleviate some of the headache pain.

6. Medication Review: If you are currently taking any medications for your headaches, discuss them with your healthcare provider. They may need to adjust your treatment plan based on your recent symptoms.

7. Avoid Triggers: Identify and avoid any known headache triggers, such as certain foods, stressors, or environmental factors.

Conclusion
Your symptoms warrant a comprehensive evaluation by a healthcare professional, particularly a neurologist, who can assess your condition more thoroughly. Given the complexity of your symptoms and the potential for serious underlying issues, it is essential to prioritize your health and seek medical advice promptly. Remember, early intervention can often lead to better outcomes in managing headache disorders.

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