Headaches and Dizziness: When to Seek Medical Attention

Headache so severe that it prevents sleep?

Hello, doctor.
Sometimes when I stand up quickly, I feel dizzy, and a few times I even see spots in front of my eyes.
I thought it was due to anemia, so I didn't pay much attention to it.
However, last night when I lay down, I experienced a throbbing headache and nausea (I had to wrap a towel around my head).
I felt a bit better when I sat up, but when I lay back down, the same symptoms returned.
It took a long time for me to fall asleep, and when I got up, I didn't feel any pain, but by the evening, I had a noticeable throbbing pain at the top of my head.
My mother usually experiences headaches before her menstrual period, but not to the extent of nausea.
I have never had headaches before my period, but this time my menstrual cycle has been irregular and has lasted for two weeks.
Should I go to the hospital for an examination, or is this just a normal hormonal imbalance?

Anastasia, 10~19 year old female. Ask Date: 2017/08/03

Dr. Jiang Junyi reply Neurology

Hello, based on your description, you are experiencing both postural dizziness and tension-type headaches.
Numerous factors can cause dizziness, such as anemia, autonomic dysfunction, and inner ear imbalance.
It is essential to rule out anemia or dehydration, which can lead to insufficient cerebral circulation.
Symptoms may improve with hydration and electrolyte replenishment.
Your symptoms seem more aligned with tension-type headaches, which may be related to posture, mental stress, or other factors causing prolonged muscle contraction, such as lack of rest or sleep, and maintaining the same posture for extended periods, leading to involuntary muscle tightness.

In addition to medication, improving your lifestyle is crucial.
Avoiding late nights, maintaining an upright spinal posture while working, and frequently changing positions or engaging in activities to relax the muscles are important.

Generally, migraines often occur before menstruation, and some migraine with aura may present with visual disturbances, such as seeing stars or lightning-like flashes, as well as blurred or distorted vision.
These are precursors to migraines.
Migraine symptoms can typically last for several hours, or even up to 2-3 days.
I recommend consulting a neurologist for further evaluation and treatment.
Wishing you good health and peace.

Reply Date: 2017/08/03

More Info

When it comes to understanding headaches and dizziness, especially in the context of your symptoms, it's essential to consider several factors that could be contributing to your discomfort. Your experience of dizziness upon standing quickly, along with headaches that are accompanied by nausea, suggests that there may be multiple underlying issues at play.

Firstly, the dizziness you experience when standing up quickly could be a sign of orthostatic hypotension, which is a drop in blood pressure that occurs when you stand up. This condition can lead to feelings of lightheadedness or dizziness and is often exacerbated by dehydration, prolonged bed rest, or certain medications. If you suspect that you might be experiencing this, it would be wise to monitor your hydration levels and consult with a healthcare provider to rule out any underlying cardiovascular issues.

The headache you described, particularly the throbbing pain that worsens with certain positions, could be indicative of a tension-type headache or even a migraine. Migraines can present with various symptoms, including nausea and sensitivity to light or sound, and they can be triggered by hormonal changes, stress, or dietary factors. Given that you mentioned a potential connection to your menstrual cycle, it’s possible that hormonal fluctuations could be influencing your headache patterns. Hormonal headaches are common and can occur in relation to the menstrual cycle, often peaking just before or during menstruation.

Your mention of a "pulsating" headache that feels better when you sit up suggests that it might be related to increased intracranial pressure or tension in the neck and shoulders. If you find that your headaches are frequent, severe, or accompanied by other concerning symptoms (such as changes in vision, persistent nausea, or neurological symptoms), it is crucial to seek medical attention. A healthcare provider may recommend imaging studies, such as an MRI or CT scan, to rule out any serious conditions like a brain tumor or vascular issues.

Additionally, the nausea you experienced alongside your headache could be a result of the headache itself or could indicate a gastrointestinal issue, especially if you have a history of gastrointestinal discomfort. It’s worth noting that stress and anxiety can also manifest physically, leading to tension headaches and gastrointestinal symptoms.
In terms of management, there are several strategies you can employ to alleviate your symptoms. For headaches, over-the-counter pain relievers such as ibuprofen or acetaminophen can be effective. However, if you find that you are relying on these medications frequently, it may be time to consult a healthcare professional for a more comprehensive treatment plan. Lifestyle modifications, such as maintaining a regular sleep schedule, staying hydrated, managing stress through relaxation techniques, and avoiding known headache triggers (like certain foods or excessive screen time), can also be beneficial.

In conclusion, while your symptoms may be related to hormonal changes or tension headaches, the combination of dizziness, nausea, and headache warrants a thorough evaluation by a healthcare provider. They can help determine the underlying cause of your symptoms and develop an appropriate treatment plan tailored to your needs. If your symptoms persist or worsen, do not hesitate to seek medical attention. Your health and well-being are paramount, and addressing these symptoms early can lead to better outcomes.

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