[45F] With severe headache, dizziness, and blurry vision

Patient Description

A 45-year-old female presents with severe headache, head pressure, hearing loss, dizziness, and blurry vision. The symptoms have been coming and going for the past 24 hours, with the headache rated as a 10 out of 10 in intensity, described as sharp, throbbing, and aching. The headache is debilitating, making it difficult for the patient to function, and resting provides only short, interrupted relief. The head pressure episodes, accompanied by blurry vision and dizziness, have been occurring for about three weeks, 2 to 3 times a day. The patient has a history of migraines and consumes about two 16 oz diet Pepsi drinks a day. She is currently taking Topiramate 100mg twice daily and Sumatriptan 25mg as needed for her headaches. No recent head injury or trauma, no changes in speech, weakness, or numbness in the body, and no nausea, vomiting, or sensitivity to light or sound during these episodes. The patient is also taking other medications but did not specify them due to the large number.

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Arora's Assessment

What might be happening

Based on the symptoms you've described—severe headache, head pressure, hearing loss, dizziness, and blurry vision—there are a few serious conditions that could be causing these symptoms:

  1. Migraine with Aura: Given your history of migraines and the severity of your headache, it's possible that you are experiencing a migraine with aura. Migraines can cause intense headaches, dizziness, and visual disturbances. However, the hearing loss and the sudden onset of symptoms are concerning and may indicate something more serious.

  2. Vestibular Migraine: This type of migraine can cause dizziness, vertigo, and balance issues, along with the typical migraine headache. The hearing loss and head pressure could be related to this condition.

  3. Transient Ischemic Attack (TIA) or Stroke: The sudden onset of severe headache, dizziness, and vision changes could be signs of a TIA or stroke. These are medical emergencies that require immediate attention.

  4. Meniere's Disease: This inner ear disorder can cause vertigo, hearing loss, and a feeling of fullness in the ear, which might explain the head pressure and dizziness.

  5. Brain Tumor or Aneurysm: Although less common, these conditions can cause severe headaches, vision changes, and other neurological symptoms.

What you can do

Given the severity and sudden onset of your symptoms, it is crucial to seek immediate medical attention. Here are the steps you should take:

  1. Go to the Emergency Room: Given the possibility of a stroke, TIA, or other serious conditions, you should go to the emergency room immediately. If you are unable to get there yourself, call 911 or have someone drive you.

  2. Monitor Your Symptoms: Keep track of any changes in your symptoms, such as worsening headache, increased dizziness, or new symptoms like weakness or numbness. Share this information with the medical professionals when you arrive at the hospital.

  3. Avoid Triggers: While waiting for medical attention, try to avoid any known migraine triggers, such as bright lights, loud noises, or strong smells.

  4. Stay Hydrated: Drink water to stay hydrated, as dehydration can sometimes worsen headaches and dizziness.

  5. Rest in a Safe Position: If you feel dizzy, lie down in a safe position to avoid falls or injuries.

Remember, I am not a doctor, and this advice is based on the information you provided. It is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Please take your symptoms seriously and get medical help right away.

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3 mo ago


People Also Ask


What are the common symptoms of a migraine with aura?

Migraine with aura can include visual disturbances such as flashing lights or zigzag patterns, sensory changes like tingling or numbness, and speech difficulties, in addition to the typical migraine headache.


How can vestibular migraines affect hearing and balance?

Vestibular migraines can cause symptoms such as vertigo, dizziness, balance issues, and sometimes hearing changes, as the vestibular system, which controls balance, is affected.


What are the warning signs of a transient ischemic attack (TIA) or stroke?

Warning signs of a TIA or stroke include sudden severe headache, dizziness, vision changes, weakness or numbness on one side of the body, difficulty speaking, and confusion. These require immediate medical attention.


What is Meniere's disease and how does it affect the body?

Meniere's disease is an inner ear disorder that can cause episodes of vertigo, hearing loss, tinnitus (ringing in the ears), and a feeling of fullness or pressure in the ear.


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