Dizziness, Headaches, and Nausea: Possible Causes - Neurology

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Dizziness, headache, and nausea?


Hello, doctor.
One night, I suddenly experienced a headache, dizziness, and nausea.
The pain is concentrated in the front of my head, while the back of my head feels heavy.
My neck is sore, but it goes away when I lie flat.
This has been ongoing for three days.
What could this possibly be? Thank you.

Xiang, 20~29 year old female. Ask Date: 2021/12/15

Dr. Jiang Junyi reply Neurology


Hello, Ms.
Hsiang:
You mentioned experiencing "severe pain in the front of the head, a heavy feeling in the back of the head, and neck soreness that resolves when lying flat." In addition to common cervical myofascial inflammation, intracranial hypotension may need to be considered as a cause of your headache.
The primary symptom of spontaneous intracranial hypotension is "postural headache," where the headache worsens when standing or sitting and significantly improves or disappears when lying down.
The more common type is bilateral, non-vascular pulsating headache.
For treatment, in addition to hydration and the intake of coffee or tea, you may also use pharmacological caffeine and theophylline.
A small number of patients may respond to corticosteroids or non-steroidal anti-inflammatory drugs (NSAIDs).
Additionally, you may consult an anesthesiologist for an epidural blood patch, which involves injecting the patient's own blood or saline, dextran, etc., directly at the site of the leak identified through MRI of the spine.
This procedure typically requires one to three sessions.
If these methods are ineffective, surgical intervention to repair the leak may be considered.
I recommend that you consult a neurologist or neurosurgeon to discuss further evaluation and treatment options.
Thank you for your inquiry, and I wish you good health and peace.
Best regards,
Dr.
Jiang, Department of Neurology, Taoyuan Hospital

Reply Date: 2021/12/15

More Info


When experiencing symptoms such as dizziness, headaches, and nausea, it is essential to consider a variety of potential causes. Your description of sudden onset headaches accompanied by dizziness and nausea, particularly with a sensation of heaviness in the back of your head and neck discomfort, raises several possibilities that warrant further exploration.

Firstly, the combination of these symptoms could indicate a tension-type headache, which is often associated with muscle tension in the neck and shoulders. This type of headache can be exacerbated by stress, poor posture, or prolonged periods of sitting, especially if you spend long hours in front of a computer. The heaviness you feel in the back of your head could be related to muscle strain or tension in the cervical spine, which may also contribute to dizziness and nausea.

Another possibility is a migraine, which can present with similar symptoms, including severe headache, nausea, and sometimes dizziness. Migraines can be triggered by various factors, including stress, lack of sleep, dehydration, or dietary triggers. If you have a history of migraines or if these symptoms are recurrent, it may be worth discussing with a healthcare provider.

Additionally, the presence of neck pain and the relief you experience when lying down could suggest a cervical spine issue, such as a herniated disc or cervical spondylosis, which can lead to nerve compression and associated symptoms. This could also explain the dizziness if there is any compromise to blood flow or nerve function.

Infections, such as viral illnesses or even sinusitis, can also present with headaches, dizziness, and nausea. If you have had any recent upper respiratory symptoms or if you feel feverish, this could be a contributing factor. Sinus pressure can lead to headaches that feel worse when bending over or lying down.

Moreover, it is crucial to rule out more serious conditions, such as intracranial issues like a concussion, intracranial hemorrhage, or other neurological conditions. If the headache is severe, persistent, or accompanied by other alarming symptoms such as visual disturbances, confusion, or loss of consciousness, it is imperative to seek immediate medical attention.

Given that your symptoms have persisted for three days, it would be advisable to consult a healthcare professional for a thorough evaluation. This may include a physical examination, neurological assessment, and possibly imaging studies such as an MRI or CT scan to rule out any serious underlying conditions. Blood tests may also be performed to check for signs of infection or other systemic issues.

In the meantime, consider maintaining a headache diary to track your symptoms, potential triggers, and any relief measures that help. This information can be invaluable for your healthcare provider in determining the underlying cause of your symptoms and formulating an appropriate treatment plan.

In summary, while your symptoms could be attributed to tension headaches, migraines, cervical spine issues, or even infections, a comprehensive evaluation by a healthcare professional is essential to identify the exact cause and initiate appropriate treatment. Remember to prioritize self-care, including proper hydration, rest, and stress management, as these can significantly impact your overall well-being.

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