Unusual Head Sensations: When to Seek Neurological Evaluation

Recently, I've been feeling strange in my head, as if there is something stuck at the back of my brain?

Hello, I have gallstones and have previously experienced vertigo, but I was taken off medication by my doctor five years ago because I hadn't had an episode in over ten years, with only three occurrences.
Recently, I experienced upper abdominal pain due to the stones and went to the emergency room for pain relief (which I have done in the past).
However, the next day I noticed dizziness and an unusual sensation in my head.
Later, my blood pressure was measured at 160/90.
I visited my primary care physician, who advised me to monitor my blood pressure daily, which has been around 110-130/70-80.
However, I still sometimes feel a heavy sensation in my head, as if the weight is shifting to the back of my skull, which feels similar to my previous episodes of vertigo, although I haven't had an actual episode.
Overall, I feel uncomfortable and am unsure where to begin with further examinations to determine the cause (I do exercise regularly).

crise, 30~39 year old female. Ask Date: 2012/04/11

Dr. Huang Zixuan reply Neurology

If you are concerned about conditions related to epilepsy, it is recommended to undergo an electroencephalogram (EEG) at a hospital.
Additionally, it is advisable to keep a record of the times when you experience these uncomfortable sensations, as having a complete record will help clarify the underlying issues.

Reply Date: 2012/04/11

More Info

Hello, thank you for sharing your concerns regarding your unusual head sensations and the associated symptoms. Based on your description, it seems you are experiencing a combination of dizziness, a feeling of heaviness in your head, and fluctuations in blood pressure. Given your medical history, including gallstones and a previous episode of vertigo, it is essential to approach this situation carefully.

First and foremost, it is important to recognize that dizziness and unusual head sensations can arise from various causes, including vestibular disorders, neurological issues, or even cardiovascular problems. Since you have a history of vertigo, it is possible that your current symptoms could be related to vestibular dysfunction. This could be due to changes in your inner ear, which plays a crucial role in balance and spatial orientation.

Your elevated blood pressure readings, particularly the 160/90 noted during your visit to the emergency department, could also contribute to your symptoms. High blood pressure can lead to headaches, dizziness, and a feeling of heaviness in the head. It is good that you are monitoring your blood pressure regularly, as managing hypertension is crucial for overall health and can alleviate some of your symptoms.

Given your symptoms and medical history, I recommend the following steps:
1. Neurological Evaluation: Since you have experienced dizziness and unusual head sensations, it would be prudent to seek a neurological evaluation. A neurologist can perform a thorough assessment, including a physical examination and possibly imaging studies like an MRI or CT scan, to rule out any structural abnormalities in the brain or issues with the cranial nerves.

2. Vestibular Testing: If your dizziness persists, consider undergoing vestibular testing. This can help determine if there is an issue with your inner ear or balance system. Tests such as the electronystagmography (ENG) or videonystagmography (VNG) can assess how well your vestibular system is functioning.

3. Blood Pressure Management: Continue monitoring your blood pressure and work with your primary care physician to manage it effectively. If you notice significant fluctuations or persistent high readings, it may be necessary to adjust your medication or explore lifestyle changes that can help lower your blood pressure.

4. Lifestyle Modifications: Since you mentioned that you have a routine exercise regimen, maintaining physical activity is beneficial. Additionally, consider incorporating relaxation techniques such as yoga or meditation, which can help reduce stress and potentially alleviate some of your symptoms.

5. Follow-Up: Given the complexity of your symptoms, it is essential to maintain regular follow-ups with your healthcare providers. Documenting your symptoms, including their frequency and intensity, can provide valuable information for your doctors.

In conclusion, while your symptoms may be related to your previous medical history, it is crucial to approach them with a comprehensive evaluation. Seeking a neurological assessment and considering vestibular testing can help identify the underlying cause of your unusual head sensations. Remember to keep an open line of communication with your healthcare providers and advocate for your health. Your well-being is paramount, and addressing these symptoms promptly can lead to better management and improved quality of life.

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