Severe Headaches, High Blood Pressure, and Nausea: Causes and Solutions

Frequent headaches, elevated blood pressure, and vomiting?

I often experience headaches, elevated blood pressure, and vomiting.
What could be the cause? My headaches are sometimes so severe that I have to go to the emergency room (my blood pressure spikes to 180-184 during these visits).
At other times, I have difficulty breathing and feel nauseous to the point of vomiting.
I have a thyroid tumor; could this be related? (However, my thyroid levels are normal.) Which specialty should I consult?

Wang Youyou, 30~39 year old female. Ask Date: 2017/01/15

Dr. Chen Taicheng reply Family Medicine

● If your outpatient blood pressure readings are consistently greater than 140/90 mmHg, or if home measurements are consistently greater than 135/85 mmHg, you may be at risk for hypertension.
Blood pressure can be elevated during periods of discomfort (such as headaches) and may not necessarily indicate hypertension; it is important to measure blood pressure when you are in good health.
Before measuring blood pressure, you should rest for 5-10 minutes and avoid exercise or stimulants, and both arms should be measured.
Depending on your age, if your blood pressure is indeed elevated, further consideration of secondary hypertension may be necessary, such as kidney disease or endocrine disorders (for example, hyperthyroidism or pheochromocytoma, which can cause episodic hypertension, headaches, chest tightness, pallor, sweating, etc.).

● There are many causes of headaches, which may also be accompanied by nausea and elevated blood pressure.
Common causes include migraines and tension-type headaches.
A small number of causes may involve intracranial lesions leading to increased intracranial pressure, meningitis, vascular diseases, or medication-related headaches (such as those caused by withdrawal from or overuse of pain medications).
● The current headache and elevated blood pressure may not be significantly related to your thyroid goiter.
It is recommended to regularly monitor your blood pressure and record the severity, frequency, duration of headaches, and any possible triggers or alleviating factors (to determine whether the headache is causing elevated blood pressure or vice versa).
Further consultation with a neurologist, cardiologist, or family medicine physician is advised.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital, Department of Family Medicine, cares for you.

Reply Date: 2017/01/15

More Info

Severe headaches, elevated blood pressure, and nausea can be concerning symptoms that warrant thorough evaluation. Based on your description, it seems you are experiencing significant distress due to these symptoms, particularly the severe headaches that lead you to seek emergency care. Let's break down the potential causes and solutions for your situation.

Potential Causes
1. Primary Headaches: Conditions like migraines or tension-type headaches could be responsible for your severe headaches. Migraines, in particular, can be associated with nausea and vomiting, and they may also cause temporary increases in blood pressure due to pain and stress.

2. Secondary Headaches: These are headaches caused by underlying conditions. Given your history of thyroid issues, it’s essential to consider whether your thyroid condition could be contributing to your symptoms. Although your thyroid levels are normal, the presence of a thyroid tumor may still have implications for your overall health and could potentially lead to headaches or other systemic symptoms.

3. Hypertension: Your reported blood pressure readings of 180-184 during headache episodes indicate significant hypertension, which can be both a cause and a consequence of severe headaches. High blood pressure can lead to headaches, and conversely, the stress and pain from headaches can elevate blood pressure.

4. Neurological Issues: Given the severity of your headaches and associated symptoms like nausea and difficulty breathing, it’s crucial to rule out any serious neurological conditions. This could include issues like intracranial hypertension, aneurysms, or other structural abnormalities in the brain.

5. Other Medical Conditions: Conditions such as anxiety disorders, which can manifest physically, may also contribute to your symptoms. Stress and anxiety can lead to elevated blood pressure and headaches, along with gastrointestinal symptoms like nausea.

Recommended Actions
1. Consult a Neurologist: Given the complexity of your symptoms, a neurologist would be the most appropriate specialist to evaluate your headaches. They can conduct a thorough assessment, including a detailed history, physical examination, and possibly imaging studies (like an MRI or CT scan) to rule out any serious conditions.

2. Monitor Blood Pressure: Keeping a log of your blood pressure readings at home can help your healthcare provider understand the patterns and triggers of your hypertension. This information is crucial for managing your blood pressure effectively.

3. Thyroid Evaluation: While your thyroid levels are normal, it may be beneficial to have a comprehensive evaluation of your thyroid condition, including imaging studies to assess the tumor and its potential effects on surrounding structures.

4. Lifestyle Modifications: Consider lifestyle changes that can help manage both headaches and blood pressure. This includes stress management techniques, regular physical activity, a balanced diet, and adequate hydration. Avoiding known headache triggers, such as certain foods, caffeine, and alcohol, may also be beneficial.

5. Emergency Care: Since you have experienced severe symptoms that led to emergency visits, it’s essential to seek immediate medical attention if you experience similar episodes in the future, especially if they are accompanied by neurological symptoms (like vision changes, weakness, or confusion).

Conclusion
In summary, your symptoms of severe headaches, high blood pressure, and nausea could stem from various causes, including primary headaches, secondary headaches due to underlying conditions, or even stress-related factors. Consulting a neurologist is a critical step in determining the underlying cause and developing an appropriate treatment plan. Additionally, managing your blood pressure and monitoring your thyroid condition will be essential components of your overall health strategy. Remember, timely intervention can significantly improve your quality of life and help alleviate your symptoms.

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