[38F] Experiencing head pressure, dizziness, and tinnitus

Patient Description

A 38-year-old female reports a 2-month history of moderate to severe pressure in the head, localized initially in the frontal region and now in the back, with associated neck discomfort. She experiences lightheadedness described as an 'off' feeling, which is worse at night and rated as moderate to severe. Additionally, she reports spontaneous ringing and popping in the ears, rated as mild in severity. She has a family history of migraines and consumes caffeine. She has been using the NuvaRing for birth control for the past four years. No other medications or supplements are being taken. There is no history of recent head injury, fever, rash, sudden changes in movement or sensation, vision changes, or loss of consciousness. She denies any known drug allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are several possible explanations for your symptoms:

  • Tension Headache: This is a common type of headache characterized by a dull, aching sensation all over the head. It is often described as a feeling of a tight band or "pressure" around the head or at the back of the head and neck. Some people may also experience tenderness of the scalp, neck and shoulder muscles.

    • Treatment typically involves over-the-counter pain relievers, stress management, and lifestyle changes such as regular physical activity and proper posture.
  • Migraine: Given your family history of migraines, this could also be a possibility. Migraines are typically characterized by moderate to severe headaches that are throbbing or pulsating and often on one side of the head. They can be accompanied by other symptoms like sensitivity to light and sound, nausea, and vomiting. Some people may also experience auras, which are sensory or visual disturbances that occur before the headache.

    • Treatment usually involves medications to relieve symptoms and prevent future attacks, as well as lifestyle modifications to avoid triggers.
  • Benign Paroxysmal Positional Vertigo (BPPV): This condition causes brief episodes of mild to intense dizziness and is usually triggered by specific changes in the position of your head. This might explain your lightheadedness.

    • Treatment involves a series of movements to help move the tiny particles in your inner ear that may be causing the dizziness.
  • Meniere's Disease: This is a disorder of the inner ear that can lead to dizziness and tinnitus, along with hearing loss and a feeling of pressure or fullness in the ear. However, it's usually limited to one ear.

    • Treatment can involve medications, physical therapy, or in some cases, surgery.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider who can evaluate your symptoms in person.

What you can do

  1. Try over-the-counter pain relievers for your headache, but be sure to follow the package instructions.
  2. Practice good posture, especially if you work at a desk or use a computer for long periods.
  3. Try to identify any potential triggers for your symptoms, such as certain foods, stress, lack of sleep, etc.
  4. Stay hydrated and maintain a balanced diet.
  5. Regular physical activity can help manage symptoms of many conditions, including headaches and dizziness.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • A sudden, severe headache that's different from past headaches
  • Weakness, numbness, or difficulty speaking
  • Vision changes
  • Trouble walking or loss of balance
  • High fever along with a headache
  • Seizures
  • Fainting or loss of consciousness
  • Persistent vomiting or nausea

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of tension headaches?

Tension headaches are typically characterized by a dull, aching sensation all over the head, often described as a feeling of a tight band or pressure around the head or at the back of the head and neck. Some people may also experience tenderness of the scalp, neck, and shoulder muscles.


How can migraines be managed or prevented?

Migraines can be managed with medications to relieve symptoms and prevent future attacks. Lifestyle modifications such as avoiding known triggers, maintaining a regular sleep schedule, staying hydrated, and managing stress can also help prevent migraines.


What is Benign Paroxysmal Positional Vertigo (BPPV) and how is it treated?

Benign Paroxysmal Positional Vertigo (BPPV) is a condition that causes brief episodes of mild to intense dizziness, usually triggered by specific changes in the position of your head. It is treated with a series of head movements known as the Epley maneuver, which helps move the tiny particles in the inner ear that may be causing the dizziness.


What lifestyle changes can help reduce the frequency of headaches?

Lifestyle changes that can help reduce the frequency of headaches include practicing good posture, especially if you work at a desk or use a computer for long periods, staying hydrated, maintaining a balanced diet, engaging in regular physical activity, and identifying and avoiding potential headache triggers such as certain foods, stress, and lack of sleep.


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