Headaches and Dizziness: When to Seek Neurological Care

Headache can suddenly make you feel faint?

Hello Doctor, I experience headaches due to poor air circulation or fatigue, which can last all day and usually resolve after a night's sleep, so I haven't sought medical attention.
However, recently I've started to experience headaches at work (starting around 4-6 PM), and sometimes I suddenly feel like I'm about to faint (whether standing or sitting), prompting me to grab onto something to prevent myself from falling.
I previously underwent a health check at Shentao and passed all the tests.
Which specialty do you recommend I see? What do you think I might be suffering from? Thank you.

Zhang Xiaojie, 20~29 year old female. Ask Date: 2017/08/22

Dr. Jiang Junyi reply Neurology

Hello, your symptoms are more indicative of tension-type headache.
The causes of this headache are currently believed to be related to non-physiological work postures, mental stress, or other factors leading to prolonged muscle contraction, such as lack of rest or sleep, and maintaining the same posture for extended periods, which can result in involuntary muscle tightness.
The headache can last from a few minutes to several hours.
The typical pain is located in the forehead and extends to the sides of the head, characterized by a feeling of pressure and tightness, with a severity ranging from mild to moderate, and it is less likely to be exacerbated by routine physical activity.
It may be accompanied by mild nausea, photophobia, or phonophobia.

In addition to medication, improving lifestyle habits is crucial for treating tension-type headaches.
This includes avoiding staying up late and drinking alcohol.
When working, it is important to maintain a proper upright spinal posture and avoid holding the same position for long periods.
Regularly changing positions or engaging in activities to relax the muscles is also recommended.
You may also learn simple muscle relaxation techniques and physical therapy exercises.
In severe cases, you may take analgesics, muscle relaxants, or medications to alleviate emotional stress as prescribed by a physician.
It is advisable to consult a neurologist for further evaluation and treatment.
Wishing you good health and peace.

Reply Date: 2017/08/22

More Info

Headaches can be a common yet complex issue, often stemming from various underlying causes. Your description indicates that you experience headaches primarily triggered by environmental factors, such as poor air circulation or fatigue, and that these headaches can last throughout the day, alleviating only after a good night's sleep. Additionally, the sensation of dizziness or feeling faint is concerning and warrants further evaluation.

Given your symptoms, it is essential to consider several potential causes. Tension-type headaches are often associated with stress, fatigue, and muscle tension, particularly in the neck and shoulders. These headaches can be exacerbated by prolonged periods of sitting or poor posture, especially in a work environment. On the other hand, migraines can also present with similar symptoms, including sensitivity to light and sound, and may be accompanied by dizziness or a feeling of impending faintness.

The fact that your headaches tend to occur later in the day, particularly between 4-6 PM, could suggest that they are related to the cumulative stress and fatigue of your workday. This pattern is not uncommon, as many individuals experience tension headaches that build up throughout the day. The dizziness you describe, especially the sensation of almost fainting, is particularly concerning. This could be related to several factors, including dehydration, low blood sugar, or even postural hypotension (a drop in blood pressure when standing up).

To address your concerns, it is advisable to seek evaluation from a healthcare professional. Given the combination of headaches and dizziness, starting with a visit to a neurologist would be prudent. A neurologist specializes in conditions affecting the nervous system, including headaches and dizziness, and can conduct a thorough assessment to determine the underlying cause of your symptoms. They may recommend imaging studies, such as an MRI or CT scan, to rule out any structural issues in the brain, especially if your symptoms persist or worsen.

In addition to seeking medical advice, there are several self-care strategies you can implement to help manage your headaches and dizziness. Here are some recommendations:
1. Hydration: Ensure you are drinking enough water throughout the day. Dehydration can lead to headaches and dizziness.

2. Regular Breaks: If you work at a desk, take regular breaks to stretch and move around. This can help alleviate muscle tension and improve circulation.

3. Posture: Pay attention to your posture while sitting. Ergonomic adjustments to your workspace can help reduce strain on your neck and shoulders.

4. Stress Management: Incorporate stress-reducing techniques into your routine, such as mindfulness, meditation, or yoga. These practices can help alleviate tension and improve overall well-being.

5. Sleep Hygiene: Ensure you are getting adequate and quality sleep. Establishing a regular sleep schedule can help improve your overall health and reduce headache frequency.

6. Diet: Monitor your diet for potential headache triggers, such as caffeine, alcohol, or certain foods. Keeping a food diary may help identify patterns related to your headaches.

7. Physical Activity: Regular physical activity can help reduce stress and tension, potentially decreasing the frequency and severity of headaches.

In conclusion, while your symptoms may initially seem manageable, the combination of persistent headaches and dizziness should not be ignored. Seeking evaluation from a neurologist will provide you with a clearer understanding of your condition and appropriate treatment options. In the meantime, implementing lifestyle changes can help mitigate your symptoms and improve your overall quality of life.

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