[56F] With severe headache, dizziness, and vision changes

Patient Description

A 56-year-old female presents with a severe, throbbing headache that is localized to the eye sockets, forehead, and below the eyes. The headache has been occurring for approximately 48 hours, starting in the evenings with a sudden onset, and is rated a 10 on the pain scale. The patient has experienced a similar headache about a year ago. Accompanying symptoms include dizziness when lying down and rolling onto the right side, described as a sensation of the eyes rapidly rolling, rated a 7 on the severity scale. This dizziness has been present for about 2 weeks. The patient also reports neck pain, slight nausea that begins a few hours after the headache starts, and vision changes characterized by increased blurriness up close. No relief from the headache was obtained with Aleve, and the symptoms persisted for a week and a half previously. No fever, neck stiffness, rash, confusion, vomiting, or sensitivity to light or sound has been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Migraine: A type of headache characterized by severe, throbbing pain, often accompanied by nausea and sensitivity to light or sound. Migraines can sometimes cause visual disturbances and dizziness.

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

  • Sinusitis: An inflammation or swelling of the tissue lining the sinuses that can cause pain, headache, and sometimes dizziness.

    • Treatment often includes nasal sprays, antibiotics, and pain relievers.

  • Vertigo: A condition where you feel like you or the room is spinning. It can be caused by issues in the inner ear or brain.

    • Treatment depends on the cause and can include medications, physical therapy, or surgery.

  • Tension headache: A common type of headache that can cause a constant ache and tightness around your forehead or at the back of your head and neck.

    • Over-the-counter pain relievers are typically effective, but your doctor may prescribe stronger medications if they're frequent.

Please note that these are potential diagnoses and it's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Try over-the-counter pain relievers like ibuprofen or acetaminophen for your headache.
  2. Rest in a quiet, dark room.
  3. Stay hydrated and try to eat regularly, even if you're not feeling hungry.
  4. Avoid activities that worsen your symptoms.

What you should look out for

You should seek immediate medical attention if:

  • Your headache is severe and sudden.
  • You have a headache accompanied by a high fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or difficulty speaking.
  • You have a headache after a head injury.
  • Your headache is worsening despite rest and pain medication.

Remember, while I strive to provide accurate information, I'm an AI and not a substitute for professional medical advice.

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10 mo ago

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People Also Ask

What are the common symptoms of a migraine and how can they be managed?

Common symptoms of a migraine include severe, throbbing headache, nausea, and sensitivity to light or sound. Management often involves medications to relieve symptoms, such as triptans or NSAIDs, and preventive measures like lifestyle changes and prescription medications.

How can sinusitis cause headaches and what are the treatment options?

Sinusitis can cause headaches due to the inflammation and swelling of the sinus tissues, leading to pressure and pain in the forehead, eyes, and cheeks. Treatment options include nasal decongestants, saline sprays, antibiotics if bacterial infection is suspected, and pain relievers.

What is vertigo and how is it related to dizziness?

Vertigo is a sensation of spinning or dizziness, often caused by problems in the inner ear or brain. It can be related to dizziness when changing positions, like lying down or turning the head. Treatment depends on the underlying cause and may include medications, vestibular rehabilitation, or lifestyle changes.

What are the differences between a tension headache and a migraine?

A tension headache typically presents as a constant ache or tightness around the forehead or neck, whereas a migraine is characterized by severe, throbbing pain often accompanied by nausea and visual disturbances. Tension headaches are usually managed with over-the-counter pain relievers, while migraines may require specific medications and preventive strategies.

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