Persistent Headaches and Dizziness: When to Seek Further Medical Evaluation

Headache

Since high school, I have frequently experienced dizziness, feeling pressure when looking at things and hearing sounds.
During high school, I underwent a sleep EEG and consulted an otolaryngologist, both of which reported normal results.
However, the dizziness persisted into college.
About a year ago, I began to experience a "thumping" pressure in my ears, along with headaches that are irregularly located.
Recently, the pain has been more pronounced on the left side, and I have noticed a soft mass on the left posterior side of my head that moves slightly within a small area.
I would like to know if I need to go to the hospital for further examination, and if so, which specialty should I consult?

Peggy, 20~29 year old female. Ask Date: 2005/04/05

Dr. Lai Lunxiang reply Neurology

Hello! 1.
If you have something on your head, please consult a surgeon.
2.
Dizziness accompanied by a thumping sound in the ears, in my opinion from a Western medicine perspective, may be caused by anxiety and poor blood circulation in the ear.
If you don't mind, please come to my clinic for an examination.
Thank you!

Reply Date: 2005/04/05

More Info

Persistent headaches and dizziness can be concerning symptoms, especially when they have been ongoing for an extended period, as you described. Given your history of dizziness since high school, along with the recent development of headaches and the sensation of pressure in your ears, it is crucial to seek further medical evaluation.
First and foremost, the presence of a soft mass that you can feel on the left side of your head is particularly noteworthy. While it may be benign, such as a lipoma (a benign fatty tumor), it could also indicate a more serious condition that requires further investigation. The combination of persistent headaches, dizziness, and the new finding of a mass warrants a thorough evaluation by a healthcare professional.

You should consider seeing a neurologist, as they specialize in conditions affecting the nervous system, including headaches and dizziness. A neurologist can perform a comprehensive neurological examination and may recommend imaging studies, such as an MRI or CT scan, to assess the brain and surrounding structures. These imaging studies can help rule out any serious conditions, such as tumors, vascular malformations, or other intracranial issues that could be contributing to your symptoms.

Additionally, since you mentioned that you have previously seen an ENT specialist and had normal results, it might be beneficial to revisit them if your ear symptoms persist or worsen. The sensation of pressure and the "popping" sound in your ears could be related to Eustachian tube dysfunction or other ear-related issues that might also contribute to your dizziness.

In terms of self-management, it is essential to maintain a healthy lifestyle, including regular sleep patterns, hydration, and stress management techniques. Avoiding known headache triggers, such as certain foods, caffeine, and stress, can also be beneficial. However, given the complexity of your symptoms, self-management alone may not be sufficient.

If you experience any of the following symptoms, you should seek immediate medical attention:
1. Sudden onset of severe headache (often described as a "thunderclap" headache).

2. Neurological symptoms such as weakness, numbness, or difficulty speaking.

3. Changes in vision or hearing.

4. Loss of consciousness or severe confusion.

5. Persistent vomiting or severe nausea.

In conclusion, given your ongoing symptoms and the recent development of a palpable mass on your head, it is highly advisable to seek further medical evaluation. A neurologist would be the most appropriate specialist to consult, and they can guide you through the necessary diagnostic steps to determine the underlying cause of your symptoms. Early intervention is key in managing any potential issues effectively.

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