Head Pressure: When to Seek Neurological Help

Inquiry about Head Pressure

Until yesterday, I had been staying up late for a week to complete assignments, with a sleep schedule of going to bed at 8 AM and waking up at 3 PM.
For the past two nights, I experienced significant swelling in my head (above the temples on both sides) and felt some difficulty with inhalation and exhalation.
This morning, I woke up feeling similarly swollen and dizzy.
Which specialist should I see, and what kind of tests should I undergo? Are there any methods to alleviate these symptoms? Thank you.

mu, 20~29 year old female. Ask Date: 2023/06/12

Dr. Jiang Junyi reply Neurology

Dear Mr.
Wood,
You mentioned that "after a week of continuous late nights...
my head is very swollen (above the temples on both sides)," and we should first consider tension-type headache.
The symptoms of this type of headache are as follows:
1.
It is often bilateral, located in the occipital and parietal regions, and sometimes the pain can be widespread.
The nature of the pain is dull, aching, pressure-like, or tight, without pulsation.
There may be tightness and stiffness in the occipital-cervical area, which is more pronounced when turning the neck, with pain intensity ranging from mild to moderate.
2.
There are tender points in the muscles at the site of pain, and sometimes pulling on the scalp can also elicit pain.
The muscles may feel stiff, and one or more nodules, known as myofascial trigger points, may be palpable.
3.
It does not interfere with daily activities; for example, the headache does not worsen with walking or climbing stairs.
4.
Fatigue, tension, excitement, anxiety, insomnia, or depression can exacerbate the headache.
Pain may be triggered by flexing and extending the head.
Tension-type headaches may be caused by stress, anxiety, or poor posture leading to excessive tightness in the muscle fascia.
In terms of treatment, it is important to identify and address the sources of stress, engage in muscle relaxation exercises such as yoga, or pay attention to posture.
Pharmacological treatment typically includes muscle relaxants, anxiolytics, and mild analgesics.
Taking a hot bath, getting a massage, or sleeping can provide relief.
Insufficient sleep, stress, or anxiety can worsen the severity of the headache.

If you wish to change your lifestyle, it is advisable to consult a psychologist and learn about healthy sleep practices for shift workers.
I recommend visiting a neurology clinic for further evaluation and follow-up.
Wishing you good health, peace, and happiness.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital

Reply Date: 2023/06/12

More Info

Based on your description, it sounds like you are experiencing significant discomfort and symptoms that could be indicative of a more serious underlying condition. The sensation of head pressure, particularly around the temples, combined with difficulty breathing and dizziness, warrants careful consideration and potentially immediate medical attention.

Given your symptoms, it would be advisable to seek help from a neurologist. Neurologists specialize in disorders of the nervous system, which includes the brain, spinal cord, and nerves. They can evaluate your symptoms in detail and determine if there are any neurological issues that need to be addressed. Additionally, if your symptoms are severe or if you experience any sudden changes, such as severe headache, confusion, weakness, or difficulty speaking, you should seek emergency medical care immediately.

In terms of diagnostic tests, a neurologist may recommend several evaluations, including:
1. Magnetic Resonance Imaging (MRI): This imaging test can provide detailed images of the brain and help identify any abnormalities, such as swelling, lesions, or other structural issues.

2. Computed Tomography (CT) Scan: Similar to an MRI, a CT scan can help visualize the brain and detect any acute issues, such as bleeding or tumors.

3. Electroencephalogram (EEG): If there are concerns about seizure activity or other electrical disturbances in the brain, an EEG may be performed.

4. Blood Tests: These can help rule out infections, inflammation, or other systemic issues that might be contributing to your symptoms.

5. Lumbar Puncture (Spinal Tap): In some cases, a doctor may recommend a lumbar puncture to analyze cerebrospinal fluid, which can provide information about infections or other conditions affecting the central nervous system.

In the meantime, there are several strategies you can employ to help alleviate your symptoms:
- Hydration: Ensure you are drinking plenty of water, as dehydration can exacerbate headaches and dizziness.

- Rest: Given that you have been staying up late, it’s crucial to allow your body to recover. Try to establish a regular sleep schedule, aiming for 7-9 hours of sleep per night.

- Stress Management: Engage in relaxation techniques such as deep breathing exercises, meditation, or gentle yoga. These can help reduce tension and improve your overall sense of well-being.

- Limit Caffeine and Alcohol: Both substances can contribute to dehydration and may worsen headaches.

- Over-the-Counter Pain Relief: If you are experiencing headaches, medications like ibuprofen or acetaminophen may provide temporary relief. However, consult with a healthcare provider before taking any medication, especially if you have other health conditions or are taking other medications.

- Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be valuable for your healthcare provider.

In conclusion, while some of your symptoms may be related to lifestyle factors such as sleep deprivation and stress, the combination of head pressure, dizziness, and difficulty breathing should not be taken lightly. Seeking evaluation from a neurologist is a prudent step to ensure that any serious conditions are ruled out and to receive appropriate care tailored to your needs. Remember, your health is paramount, and addressing these symptoms early can lead to better outcomes.

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