[44F] With severe headache, nausea, dizziness, and blurred vision

Patient Description

A 44-year-old female presents with a severe, sharp, and squeezing headache located in the front left of her forehead and the base of her neck, persisting for 3 days. The headache is rated 9/10 in intensity and is exacerbated by movement. The patient finds some relief by applying pressure to the middle of her forehead. Additional symptoms include nausea, dizziness, blurred vision, and neck stiffness. The headache onset was sudden, and the pain is constant, primarily at the base of the head near the neck. The patient has a history of a head injury 3 months ago, which resulted in loss of consciousness. Imaging studies (CT scan or MRI) post-injury showed no abnormalities. The patient has hypertension but has not been taking her prescribed medication regularly. She reports high blood pressure, chest pain when lying down, and swelling in her legs and feet. Medications taken for the headache include ibuprofen and Tylenol, with no significant relief. The patient's medical history includes psoriasis, hypertension, and an aortic aneurysm. She has a known allergy to sulfa drugs.

Arora's Assessment

What might be happening

Based on the information you’ve provided, several serious conditions could be contributing to your symptoms:

Hypertensive Crisis: Given your history of hypertension and the fact that your blood pressure is very high, you could be experiencing a hypertensive crisis. This is a severe increase in blood pressure that can lead to a stroke or other serious health issues. Symptoms can include severe headache, blurred vision, nausea, and dizziness.
Cervical Spine Issues: The sharp, squeezing headache at the base of your neck, along with neck stiffness, could indicate a problem with your cervical spine, such as a herniated disc or cervical spondylosis. These conditions can cause significant pain and neurological symptoms.
Post-Concussion Syndrome: Since you had a head injury three months ago and lost consciousness, it's possible that you are experiencing post-concussion syndrome. This can cause persistent headaches, dizziness, and blurred vision.
Aortic Aneurysm Complications: Given your history of an aortic aneurysm, it is crucial to rule out any complications related to this condition, as they can be life-threatening.

What you can do

Seek Immediate Medical Attention: Given the severity of your symptoms and your medical history, it is crucial to seek immediate medical attention. Go to the nearest emergency room or call 911. Do not drive yourself; have someone else take you or call for an ambulance.
Monitor Your Symptoms: While waiting for medical help, keep track of any changes in your symptoms, such as worsening headache, increased dizziness, or any new symptoms like chest pain or shortness of breath.
Avoid Physical Activity: Rest as much as possible and avoid any physical activity that could exacerbate your symptoms.
Medication: Continue taking over-the-counter pain relievers like ibuprofen or Tylenol if they provide some relief, but do not exceed the recommended dosage. Inform the medical professionals about all the medications you have taken.
Hydration: Stay hydrated by drinking water, but avoid caffeine and alcohol, as they can worsen your symptoms.

Remember, I am not a doctor, and it is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Your symptoms are serious and require immediate medical attention.

1

Hugs

0

Comments

Save

4 mo ago

Guest

[44F] With severe headache, nausea, dizziness, and blurred vision

What might be happening

What you can do

Experiencing symptoms?