[21F] Experiencing headaches, dizziness, and vision changes

Patient Description

A 21-year-old female presents with a 6-month history of throbbing headaches localized at the base of the skull, which are exacerbated by laughing, coughing, bending over, or turning the head. The headaches are described as mild to moderate in severity but can become severe when laughing. Relief is found by rubbing the back of the head. The patient also reports chronic tinnitus rated at a severity of 5 out of 10, which has been present for approximately 11 years. Additional symptoms include occasional dizziness, eye strain, muffled hearing when moving in certain ways, and transient vision darkening when bending over or turning the head. There is no reported history of head injury or exposure to loud noises that could account for the auditory symptoms.

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Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

  • Migraines: These are severe, recurring headaches that can cause symptoms like throbbing pain, light sensitivity, and vision changes. Migraines can sometimes be triggered by certain movements or actions, like coughing, laughing, or bending over.

    • Treatment typically involves medications to relieve symptoms and prevent future migraines.
  • Tension headaches: These are often described as a constant band-like pain around the head, and can be associated with neck pain or discomfort. They can be triggered by stress, poor posture, or eye strain.

    • Treatment usually involves over-the-counter pain relievers and lifestyle changes to manage stress.
  • Benign paroxysmal positional vertigo (BPPV): This condition causes brief episodes of mild to intense dizziness, usually triggered by specific changes in the position of your head. This could explain your dizziness and darkening vision when bending over or turning your head.

    • Treatment typically involves maneuvers performed by a doctor to help alleviate symptoms.
  • Tinnitus: This is the perception of noise or ringing in the ears, and can be associated with many types of hearing loss. It can also be a symptom of an underlying condition, such as age-related hearing loss, an ear injury or a circulatory system disorder.

    • Treatment involves identifying and managing the underlying cause. If a specific cause is not found, your doctor may provide strategies to help manage the noise.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to relieve your symptoms or figure out what's going on:

  1. Try over-the-counter pain relievers for your headaches, but do not exceed the recommended dosage.
  2. Practice good posture and take frequent breaks if you're doing activities that strain your eyes, like reading or looking at a computer screen.
  3. Stay hydrated and eat a balanced diet.
  4. Try to identify and avoid any triggers for your migraines, like certain foods or stress.

What you should look out for

Reasons to see a doctor more urgently:

  • If your headaches become more frequent or severe
  • If you experience sudden, severe headaches
  • If your headaches are accompanied by fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or difficulty speaking
  • If your tinnitus is accompanied by hearing loss or dizziness

Remember, I'm an AI and this advice is not a substitute for professional medical advice. Always seek the advice of your healthcare provider with any questions you may have regarding your medical condition.

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10 mo ago

People Also Ask


What could be causing headaches that worsen with laughing, coughing, or bending over?

Headaches that worsen with laughing, coughing, or bending over could be caused by migraines or tension headaches. Migraines can be triggered by certain movements, while tension headaches may be related to stress or poor posture. It's important to consult a doctor for a proper diagnosis.


How can tinnitus be managed if there is no clear underlying cause?

If there is no clear underlying cause for tinnitus, management strategies may include using sound therapy, hearing aids, or cognitive behavioral therapy to help cope with the noise. It's important to consult a healthcare provider for personalized advice.


What are the common symptoms and treatments for benign paroxysmal positional vertigo (BPPV)?

BPPV is characterized by brief episodes of dizziness triggered by changes in head position. Treatment often involves specific head maneuvers performed by a doctor to reposition the small crystals in the inner ear that cause the dizziness.


When should someone with chronic headaches and tinnitus see a doctor urgently?

You should see a doctor urgently if your headaches become more frequent or severe, are accompanied by symptoms like fever, stiff neck, confusion, seizures, or if your tinnitus is accompanied by hearing loss or significant dizziness.


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