[39F] Experiencing sudden head fullness and pulsatile tinnitus

Patient Description

A 39-year-old female reports a sudden onset of head fullness, predominantly on the sides, and concurrent pulsatile tinnitus when transitioning from sitting to standing. This has been occurring for approximately one month, with a severity rated at 6 out of 10. The patient does not report any relief from these symptoms. There is no history of severe headaches, vision changes, dizziness, or lightheadedness associated with the head fullness. The patient has no known allergies, is not on any medications, and has no pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are a few possible conditions:

  • Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down. It can cause feelings of lightheadedness, but it's less common for it to cause a sensation of fullness in the head.

    • Treatment typically involves lifestyle changes, such as standing up slowly and ensuring adequate hydration. In some cases, medication may be prescribed.
  • Benign Intracranial Hypertension (BIH): Also known as pseudotumor cerebri, this condition occurs when there is increased pressure in the fluid surrounding the brain. This can cause symptoms such as a feeling of fullness or pressure in the head, pulsatile tinnitus, and in some cases, visual disturbances.

    • Treatment often involves medications to reduce the pressure. In severe cases, surgical procedures may be necessary.
  • Migraine: While you don't report the typical severe headache associated with migraines, some people experience a sensation of pressure or fullness in the head during a migraine episode. Pulsatile tinnitus can also occur.

    • Treatment typically involves medications to treat the symptoms and prevent future attacks.

Please remember that these are just possibilities, and it's important to consult with a healthcare professional for an accurate diagnosis.

What you can do

While waiting for your appointment with a healthcare professional, here are some things you can do:

  1. Monitor your symptoms: Keep a record of when your symptoms occur, their severity, and any potential triggers. This information can be helpful for your healthcare provider.

  2. Stay hydrated: Dehydration can sometimes contribute to feelings of pressure in the head. Make sure you're drinking enough fluids throughout the day.

  3. Stand up slowly: If your symptoms are due to orthostatic hypotension, standing up slowly can help reduce the sudden change in blood pressure.

  4. Limit salt intake: If your symptoms are due to BIH, reducing your salt intake can help manage the condition.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • A sudden, severe headache
  • Vision changes, such as blurriness, double vision, or loss of vision
  • Difficulty walking or loss of balance
  • Fainting or loss of consciousness
  • Severe nausea or vomiting

Remember, it's important to consult with a healthcare professional for an accurate diagnosis and treatment.

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1 yr ago

Top picked over-the-counter products for Orthostatic Hypotension: American Heart Association Guidelines

People Also Ask


What is pulsatile tinnitus and what causes it?

Pulsatile tinnitus is a condition where you hear a rhythmic sound that often matches your heartbeat. It can be caused by changes in blood flow in the vessels near your ear or increased pressure in the brain.


How can benign intracranial hypertension be diagnosed?

Benign intracranial hypertension is typically diagnosed through a combination of a physical exam, imaging tests like an MRI or CT scan, and sometimes a lumbar puncture to measure the pressure of cerebrospinal fluid.


What lifestyle changes can help manage orthostatic hypotension?

To manage orthostatic hypotension, you can make lifestyle changes such as standing up slowly, increasing fluid and salt intake (if advised by a doctor), wearing compression stockings, and avoiding alcohol.


Are there any specific triggers for migraines that I should be aware of?

Common triggers for migraines include stress, certain foods and drinks (like caffeine, alcohol, and aged cheeses), hormonal changes, lack of sleep, and sensory stimuli such as bright lights or strong smells.


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