Dizziness (lightheadedness) – Illnesses & conditions

Dizziness is a common symptom that’s not usually a sign of anything serious, but should be investigated by a doctor.

The term “dizziness” means different things to different people – some use it to describe feeling lightheaded or off balance, while others use it to describe a feeling that their surroundings are spinning.

Because the symptom is quite vague and can be caused by a wide range of things, it may not always be easy to identify the underlying cause of dizziness.

This page explains what you should do if you feel dizzy for no apparent reason, and outlines the most common causes.

Seeing your GP 

See your GP if you’re feeling lightheaded or off balance and you’re worried, particularly if you also have other symptoms, such as fainting episodes or headaches.

Your GP will first want to establish exactly what you mean by dizziness, and check that you’re not actually describing vertigo – a severe type of dizziness, where you feel your surroundings are spinning or moving.

They’ll also want to know:

• whether the dizziness started for no apparent reason, or if it followed an illness
• whether you have repeated episodes of dizziness and, if so, when you tend to experience these
• how long the dizziness lasts

Dizziness can sometimes be caused by an ear condition. A simple way of distinguishing between ear-related dizziness and dizziness due to other causes is to determine whether it occurs only when you’re upright or also when you’re lying down.

Dizziness that occurs when you’re upright is probably not related to the ear. Dizziness that happens when you’re lying down is usually caused by a viral ear infection, which can’t be treated with antibiotics.

It’s a good idea to keep a diary of your dizziness, recording when and where you experience the problem, and take it with you to your GP appointment. It’s helpful to note:

• what you were doing at the time of your dizziness
• how long it lasted and how bad it was
• whether you had any other symptoms – such as fainting, vomiting, nausea, blurred vision, headache, hearing loss or tinnitus

If you’re taking prescription medicine, your GP will probably review this to check whether dizziness is a possible side effect. If necessary, they can prescribe a different medication for you to try.

You may be referred to a specialist for further tests and investigations.

Common causes of dizziness

The most common causes of dizziness are outlined below.

• Labyrinthitis – an inner ear infection that affects your hearing and balance, and can lead to a severe form of dizziness called vertigo.
• Migraine – dizziness may come on before or after the headache, or even without the headache.
• Stress or anxiety – particularly if you tend to hyperventilate (breathe abnormally quickly when resting).
• Low blood sugar level (hypoglycaemia) – which is usually seen in people with diabetes.
• Postural hypotension – a sudden fall in blood pressure when you suddenly sit or stand up, which goes away after lying down. This is more common in older people.
• Dehydration or heat exhaustion – dehydration could be due to not drinking enough during exercise, or illness that causes vomiting, diarrhoea or fever.
• Vertebrobasilar insufficiency – decreased blood flow in the back of the brain, which may be caused by the blood vessels that lead to the brain from the heart being blocked (known as atherosclerosis).

Less common causes of dizziness

Less common causes of dizziness include:

Migraines & Headaches with Dizziness, Vertigo, or Vision Problems

Many people who get migraines also have problems with their vision as well as dizziness or vertigo along with the headaches.

These effects can be scary and troubling. But they usually get much better or even disappear with treatment. Lifestyle changes, medications, and complementary therapies can help migraines and their related symptoms.

Vision Problems

About 1 in 4 people who suffer from migraines will get an aura, which often includes visual symptoms:

• Blind spots
• Flashing lights
• Spots of light
• Wavy lines in your field of vision

Vision problems usually start 20 minutes to an hour before the headache. Even if you don’t get an aura, the headache itself may cause vision trouble.

A retinal migraine causes a variety of visual symptoms, possibly blindness in one eye, before and during the headache. Fortunately, these problems go away with it, but permanent vision loss may be a complication of this type of migraine.

Other serious conditions, such as optic nerve problems or a tear in the arteries that supply blood to your brain, can also cause one-sided blindness. See your doctor as soon as you can to rule them out.

Vertigo and Dizziness

Migraines are one of the leading causes of dizziness. About one-fourth of the people in the U.S. who have migraines get this uncomfortable symptom. Dizziness and vertigo are more common when you have migraines with aura.

You may feel lightheaded or unsteady — vertigo makes it seem like the room is spinning. It may happen before or at the same time as the headache. Sometimes you won’t get a headache at all. The symptoms may last anywhere from a few seconds to days.

The sensations are actually related to your inner ear. In fact, some people who have vertigo with their migraines also have other ear and hearing problems such as sound sensitivity and ringing in their ears.

A basilar-type migraine, what doctors call migraine with brainstem aura (MBA), is the most likely to cause vertigo. It’s also likely to cause ringing in the ears, hearing loss, and coordination difficulties.

Some people who have migraine-related vertigo don’t get this symptom until several years after their headache episodes begin.

Doctors have a hard time diagnosing vertigo caused by migraine. That’s because people who have these headaches often have other conditions that may cause dizziness, too, including anxiety, and low blood pressure related to their body position.

Treatment for Migraines and Related Symptoms

Many people can lessen or get rid of their headache and its problems by changing their daily habits:

No surefire medication will work for everyone who gets migraines. But you have options that, alone or in combination, can relieve the headaches and associated vision issues, dizziness, and vertigo.

Some prescriptions block migraines before they start.

• Amitriptyline (Elavil, Endep), an antidepressant
• Topiramate (Topamax), a seizure medication
• Verapamil (Calan, Calan SR, Covera HS, Verelan, Verelan PM), also used for high blood pressure, chest pain, and irregular heart rhythm
• Eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy) and galcanezumab (Emgality) are CGRP inhibitors  that blocks the effects of calcitonin gene-related peptide molecules

Your doctor may prescribe drugs called triptans, including rizatriptan (Mazalt) and sumatriptan (Alsuma) to stop migraines before they become full-blown.

A new class called ditans which includes lasmiditan (Reyvow) may be a safer option if you are older or have certain heart problems. Gepants such as rimegepant (Nurtec) and ubrogepant (Ubrelvy) block CGRP to help stop migraines in their tracks.

Continued

There are a couple of devices designed to short-circuit a migraine by turning on your brain in a particular way. A device called SpringTMS uses a technique called a transcranial magnetic stimulation (TMS). Place it on the back of your head for about a minute for release of a pulse of magnetic energy. Similarly, Cefaly uses transcutaneous supraorbital nerve stimulation and is worn as a headband on the forehead and turned on daily for 20 minutes to prevent migraine from developing. There is also a noninvasive vagus nerve stimulator called gammaCore. When placed over the vagus nerve in the neck, it releases a mild electrical stimulation to the nerve’s fibers to relieve pain. These three devices can be used to both prevent and treat migraines. A remote electrical neuromodulation device called Nerivio is also available for treatment of migraines only.

You’ll need a prescription for any of these gadgets, too.

Both prescribed and over-the-counter pain relievers and anti-inflammatory drugs, such as acetaminophen, ibuprofen, and naproxen, may give you relief from the migraine’s effects.

Biofeedback and acupuncture can help you manage your stress as well as headache pain and other sensations.

Headache, dizziness, fatigue, and neck pain: Causes and treatment

There can be several reasons for a headache with neck pain, dizziness, and fatigue.

Cervical headache

A cervical headache, or cervicogenic headache, is a type of long-term or chronic headache due to structural issues with parts of the cervical spine, including the vertebrae, disc, muscle, or spinal cord. The cervical spine is the section of the spine that includes the neck.

Cervical spine damage can occur due to:

• injury resulting from accidents or surgery
• compression fractures
• a herniated disk
• inflammation of the spinal cord
• general neck strain due to posture issues

A cervical headache may cause pain that persists for several days, or the discomfort can come and go. Other possible symptoms include:

Treatment

A doctor can usually diagnose cervical headaches by examining the neck and assessing the spine using medical imaging techniques.

The treatment will depend on the underlying cause, with options that include:

• pain relievers to ease neck pain and headaches
• physiotherapy to restore function and improve neck movement
• surgery to correct issues with the cervical spine
• nerve blocks to treat specific areas of pain

Migraine

A migraine is a moderate or severe throbbing headache that occurs on one side of the head. They may also cause additional symptoms, such as:

• increased sensitivity to light or sounds
• dizziness
• nausea
• vomiting

The exact cause of migraines remains unknown. However, experts believe that the following factors may play a role:

• changes in brain chemicals
• changes to the nerves and blood vessels inside the brain
• genetic factors

Some people report that certain factors can trigger their migraines, which commonly include:

Treatment

Although there is no cure for migraines, certain treatments can help reduce the symptoms, including:

• sleeping or lying in a dark room during a migraine
• taking over-the-counter pain relievers, such as acetaminophen and ibuprofen
• taking triptans, which help reverse brain-changes that can trigger migraines
• taking antiemetics to help reduce nausea and vomiting

Viral gastroenteritis

Gastroenteritis is the medical term for inflammation and irritation of the gastrointestinal tract. Viral gastroenteritis (VG) is gastroenteritis that occurs as a result of a viral infection.

Many viruses can trigger VG. The most common is norovirus, which can cause a range of symptoms, including:

Persistent diarrhea and vomiting can also lead to dehydration. This may lead to additional symptoms, such as:

• dizziness when standing up
• dry mouth and throat
• reduced urine

Treatment

Viral gastroenteritis usually goes away on its own without medical treatment. Until then, people can take medications to control their diarrhea. Examples include loperamide (Imodium) or bismuth subsalicylate (Pepto Bismol).

People can help prevent dehydration by:

• drinking plenty of water and other clear fluids
• drinking low-sugar fruit juices or sports drinks to help replace lost electrolytes

Contact a doctor if symptoms do not improve within a few days.

Cerebral aneurysm

An aneurysm refers to an enlarged blood vessel. This occurs due to a weakness in the blood vessel wall. An aneurysm that occurs within a blood vessel in the brain is known as a cerebral aneurysm.

A small cerebral aneurysm that does not increase in size might not come with any symptoms. However, larger aneurysms may put pressure on the surrounding nerves or brain tissue, which can trigger the following symptoms:

• pain above and behind the eye
• changes in vision
• a dilated pupil in the eye
• paralysis on one side of the face
• numbness
• weakness

In some cases, an aneurysm may leak or rupture, which requires emergency medical attention. Symptoms to look out for include:

Treatment

According to the National Institute of Neurological Diseases and Stroke (NINDS), not all aneurysms require treatment. In some cases, a doctor may recommend monitoring them for signs of growth.

NINDS recommend people take the following steps to help reduce the risk of a ruptured aneurysm:

Some people may require surgery to reduce or cut off blood supply to the aneurysm.

Stroke

A stroke is a potentially life threatening condition where the blood supply to part of the brain becomes cut off, which can result in brain cell death. A stroke can occur for the following reasons:

• an artery that supplies blood to the brain becomes blocked
• blood vessel within the brain ruptures

A sudden and severe headache can sometimes be a warning sign of stroke, though it is not a common symptom. In a 2015 study, only 49 out of 263 people who experienced a stroke reported a simultaneous headache.

Besides a headache, other possible stroke symptoms include:

• sudden numbness or weakness in a limb, or on one side of the face
• vision problems in one or both eyes
• difficulty speaking or understanding speech
• confusion
• dizziness
• loss of balance
• lack of coordination
• difficulty walking

Treatment

A stroke is a medical emergency. Without rapid treatment, it may result in severe brain damage or death. A person who shows signs of a stroke should phone for an ambulance immediately if possible. People should also look out for these symptoms in others and seek emergency medical care if they suspect a stroke.

Stroke treatments depend on the underlying cause. Some possible options include:

• Thrombolytics: Medications can help break up blood clots.
• Endovascular procedure: A procedure where a surgeon guides surgical instruments through a tube inserted into a limb to repair a broken blood vessel.
• Surgical treatment: Involves placing a metal clip around a ruptured blood vessel to reduce further bleeding.

Brain tumor

A brain tumor is when a collection of cells within the brain multiply abnormally and uncontrollably.

Doctors classify brain tumors into grades, depending on how fast they grow and how likely they are to grow back after treatment.

Grade 1 and 2 brain tumors are non-cancerous or benign, and slow-growing. Grade 3 and 4 brain tumors are cancerous or malignant. These tumors may originate in the brain or may spread from elsewhere in the body. They are fast-growing and more likely to re-occur following treatment.

Brain tumor symptoms depend partly on the area of the brain that they affect. Some common symptoms include:

• headaches
• dizziness
• seizures
• persistent nausea
• vomiting
• drowsiness and fatigue
• progressive weakness or paralysis on one side of the body
• problems with speech, vision, or memory
• changes in personality or behavior

Treatment

Brain tumor treatments depend on the following factors:

• type, grade, and location of the tumor
• how abnormal the cells are
• how big the tumor is and how far it has spread
• the person’s overall health and fitness

Some possible treatment options include:

• steroids to reduce swelling around the tumor
• antiepileptic medications to control seizures
• pain medications to ease pain
• surgery to remove the tumor
• radiation therapy or chemotherapy to help destroy any abnormal cells

Vestibular Migraine | Johns Hopkins Medicine

Migraine headaches are a common neurological condition. Although common migraines are characterized by a moderate to severe pounding or throbbing headache, vestibular migraine may or may not involve headaches in combination with vestibular symptoms such as vertigo, imbalance, nausea and vomiting.

Vestibular Migraine Symptoms

Although subjective hearing symptoms (ringing, fullness, pressure in one or both ears) are common, significant hearing loss should raise suspicion for an inner ear disorder such as Méniére’s disease.

With a vestibular migraine, the person may experience a combination of vestibular attacks, visual aura, or sensitivity to visual stimulation and motion at different times, and they can occur with or without an actual headache.

What causes vestibular migraine?

Vestibular migraines, like other migraine syndromes, tend to run in families. Although science has not completely clarified the complex mechanisms of migraine, it is known that women tend to suffer more from the condition than men, and symptoms may get worse around menstruation.

In addition, people vulnerable to vestibular migraines can experience episodes after migraine triggers including altered sleep patterns, MSG, menstrual cycle and food such as chocolate, ripened or aged cheese and red wine.

Vestibular Migraine Diagnosis

Because a majority of people who have vestibular migraine do not have vestibular symptoms and headaches occurring at the same time, the onset of dizziness by itself may make it challenging to arrive at a diagnosis. Other diagnostic considerations that can present similarly to vestibular migraine include:

It is common for vestibular migraine, Méniére’s disease and BPPV to coexist, which can make diagnosis and treatment even more challenging.

Vestibular Migraine Treatment

Treatment for vestibular migraine is similar to that for other migraine headaches. Use of meclizine or other abortive medications that suppress the vestibular system should be minimized, and only used occasionally as needed, during an episode for instance.

If the person is getting frequent attacks, the doctor may recommend one or more of these medications, as well as others:

People with vestibular migraines can reduce the number and intensity of episodes by maintaining a regular sleep and meal schedule, avoiding triggers, exercising regularly and managing stress.

Why am I dizzy? 10 causes

Dizziness refers to a range of sensations, such as feeling as though the room is spinning, lightheadedness, and feeling physically unsteady. Dizziness has many possible causes, which may relate to a person’s external environment, the medications they take, or an underlying condition.

Recurring dizziness or severe dizzy spells can significantly interfere with a person’s life. It rarely indicates a medical emergency, however. People can experience dizziness after:

• spinning around quickly
• standing or sitting up too fast
• engaging in high-intensity exercise

Usually, people will be able to identify the cause of their dizziness. However, this symptom may occur unexpectedly or without any clear reason.

The causes of dizziness can range from temporary physical changes to more serious underlying medical conditions, some of which we will detail below.

Many people use the terms “vertigo” and “dizziness” interchangeably.

Although these conditions create similar sensations, they are slightly different.

When someone feels dizzy, they can feel woozy or disoriented. Vertigo, on the other hand, refers to the artificial sensation of movement. Vertigo can cause people to feel as though the environment around them is spinning or tilting.

Vertigo occurs due to the development of problems in the inner ear. Causes of vertigo can include:

Benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo develops when calcium carbonate particles collect in the inner ear canals.

These canals send information about the body’s position and movements to the brain, but the presence of the calcium particles causes the brain to misread the information.

Ménière’s disease

This inner ear condition has no known cause, but some scientists believe that it can occur when fluid builds up in the ear canals.

Ménière’s disease can develop suddenly and without any apparent cause. It can give rise to vertigo, a ringing or roaring sound in the ears, and hearing loss.

Labyrinthitis

Infections can cause inflammation in the inner ear, or labyrinth. Labyrinthitis tends to develop after a viral infection, such as a cold or flu.

Antiviral and antihistamine medications can effectively treat labyrinthitis. However, parts of the inner ear may sustain permanent damage as a result of this condition.

Repetitive motion from being in a vehicle, such as a car, airplane, or boat, can disrupt the structures of the inner ear, causing dizziness, nausea, and vomiting. People call this “motion sickness” or “seasickness.”

Being pregnant or taking certain medications can increase a person’s sensitivity to motion and increase their risk of experiencing motion sickness. The symptoms of motion sickness usually subside away once the person sets foot on solid ground.

A migraine is a type of recurring headache that can cause a throbbing or pulsing pain on one side of the head. The American Migraine Foundation estimate that 30–50% of people will experience dizziness during a migraine episode.

Sometimes, people experience dizziness before the onset of a migraine episode. Other neurologic symptoms, or auras, can precede the pain of a migraine headache. Auras can affect a person’s vision, speech, and motor control.

A sharp drop in blood pressure can cause a brief sensation of lightheadedness. Blood pressure changes can occur after sitting or standing up too quickly.

Other conditions that can cause blood pressure changes include:

Taking certain medications, such as diuretics, beta-blockers, or antidepressants, can also cause changes in blood pressure.

Conditions that affect the cardiovascular system, such as the buildup of plaque in the arteries and congestive heart failure, can cause dizziness. People may experience dizziness or feel lightheaded before or after a heart attack or stroke.

If a person has cardiovascular disease, they will likely experience other signs and symptoms, including:

• irregular heartbeat
• shortness of breath
• discomfort or tightness in the chest
• a persistent cough
• excess fluid in the arms, legs, or feet
• fatigue
• nausea, vomiting, or both

Iron deficiency can result in a condition called anemia, in which the body does not have enough oxygen-rich blood.

Anemia can cause the following symptoms:

• dizziness
• shortness of breath
• chest pain
• fatigue

Making appropriate dietary changes and taking iron supplements can help treat mild forms of iron-deficiency anemia. People who have a severe iron deficiency may require a blood transfusion.

Hypoglycemia occurs when blood glucose, or blood sugar, falls below the normal levels. Causes of hypoglycemia include:

• skipping meals
• consuming alcohol
• taking certain medications, such as insulin or aspirin
• having hormonal imbalances

Symptoms of hypoglycemia can appear suddenly and vary in severity. A few of these symptoms include:

• dizziness or lightheadedness
• loss of balance
• fatigue
• headache
• hunger
• mood changes
• difficulty concentrating
• irregular heartbeat

Autoimmune inner ear disease (AIED) refers to any condition wherein the immune system mistakenly attacks the inner ear. AIED can cause hearing loss in one or both ears.

Other symptoms of AIED include:

• dizziness
• tinnitus, or ringing in the ears
• loss of balance or coordination

AIED causes nonspecific symptoms that are similar to those of an ear infection. For doctors to accurately diagnose AIED, they need to take a full medical history, perform a physical examination, and track any additional symptoms.

People who have AIED may develop another autoimmune disease that affects the entire body.

Long-term or chronic stress may contribute to the development of significant health problems, such as depression, anxiety, heart disease, diabetes, or immune dysfunction.

During the stress response, the brain releases hormones that affect the respiratory and cardiovascular systems.

These hormones narrow the blood vessels, raise the heart rate, and cause rapid, shallow breathing. These responses can lead to dizziness or lightheadedness.

Other symptoms of stress include:

• sweating
• trembling or shaking
• headaches
• chest pain
• rapid heartbeat
• difficulty sleeping
• difficulty concentrating
• nausea

Dizziness is a common symptom of anxiety. However, the exact relationship between the two varies among people.

Some people may experience anxiety attacks that trigger dizziness, while others might have a sudden onset of dizziness that triggers an anxiety attack.

Stressful events, such as an exam or a challenging emotional situation, can trigger anxiety attacks. People may feel dizzy, disoriented, and nauseous during an anxiety attack.

Other symptoms of anxiety include:

• worry
• restlessness or fidgeting
• difficulty concentrating
• sleep problems
• mood changes
• irritability
• rapid heart rate
• headache
• sweating
• dry mouth

Dizziness may indicate a more serious underlying medical condition when it occurs alongside symptoms such as:

• double vision
• vomiting
• fever
• numbness
• difficulty moving or controlling the arms or legs
• headache
• chest pain
• loss of consciousness

Experiencing an episode of sudden or severe dizziness can be alarming. However, the dizziness usually resolves on its own and does not require emergency medical attention.

Dizziness is a nonspecific symptom that can indicate an underlying medical condition, such as anxiety, stress, or low blood sugar.

People should speak with their healthcare provider if they experience severe or recurring dizziness.

Vestibular migraine – The Migraine Trust

What is vestibular migraine?

Vestibular migraine (also referred to as migrainous vertigo, migraine-related dizziness, vestibular migraine or migraine with prominent vertigo) is a type of migraine where people experience a combination of vertigo, dizziness or balance problems with other migraine symptoms.

Migraine is usually associated with a range of typical symptoms alongside headache including nausea and/or vomiting, sensitivity to light (photophobia), sensitivity to sound (phonophobia) and a sensitivity to movement (for some people exercise can make their headache worse). These symptoms all feature in the criteria used to diagnose migraine.

However, there are other migraine symptoms that are not included in the criteria used to make a diagnosis (despite them being common). These include vertigo, sensitivity to smells (osmophobia), light causing pain not just sensitivity (photic allodynia) and sensitivity to touch on the head or face (cranial allodynia).

What is vertigo?

Vertigo can be defined as a sensation of motion. For some people it is described as a spinning dizziness (external vertigo), for others it’s a sensation of swaying (internal vertigo).

The best way to work out which one you may be experiencing is whether it is the world that is moving, or is it yourself?

Vertigo can be spontaneous and can also be triggered by position (standing up or lying down), head movement or visually-induced.

Vertigo can be very disabling and very prominent in migraine. This is why vestibular migraine has its own category in the International Classification of Headache Disorders (ICHD-3).

Symptoms

The symptoms of vestibular migraine are vertigo or dizziness (vestibular symptoms) alongside other migraine symptoms such as headache, nausea, sensitivity to light and sound and aura (visual disturbances, sensory disturbances, motor disturbances).

It is possible for people to have vertigo attacks without any headache. However, for vestibular migraine to be diagnosed migraine headache should be present at some point.

Diagnosis

Many people with symptoms of vestibular migraine are seen by ear, nose and throat (ENT) specialists and neuro-otologists (experts in dizziness and balance disorders). People may be more likely to see these specialists (rather than a general neurologist or headache specialist) when they have vertigo symptoms without any headache.

According to the ICHD-3 the diagnosis of vestibular migraine needs:

• at least five episodes
• a present or past history of migraine
• vestibular symptoms (vertigo or dizziness) lasting between five minutes and 72 hours
• the concurrence of migraine headache or other migraine associated symptoms in at least half of the episodes.

As shown in the diagnostic criteria, the length of the vertigo attacks or ‘dizzy spells’ may be different for different people. For many people these would last for hours but others report their vertigo attacks could last for minutes or days and a minority reports that they last for seconds.

Ruling out other vestibular disorders may be needed. This is where management by a range of professionals, such as GPs, neurologists and neuro-otologists or ENT specialists is recommended.

The vestibular function tests (these assess the inner ear balance organs and identify if one or both are working properly) should show that vestibular function (in people with suspected vestibular migraine) is within normal limits Abnormal results in vestibular function tests should lead to the suspicion of other vestibular disorders such as Meniere’s disease.

Treatment

Treatment of vestibular migraine is similar to that of other types of migraine, with special focus on standard migraine preventive medications such as amitriptyline, propranolol, candesartan, flunarizine. Flunarizine is not available through the GP but is available from headache clinics and often a preventive of choice in this setting. Greater Occipital Nerve blocks may also be used in this setting.

The acute treatment of the headache attacks is the same as the usually recommended for migraine. This is based on migraine-specific medications, triptans or non-specific such as non-steroidal anti-inflammatory drugs (naproxen, ibuprofen, etc) and acetaminophen (Paracetamol). Opioids should be avoided. For the vertigo attacks a short course of prochlorperarzine may be beneficial as a potential vestibular sedative, and antiemetic medications such as ondansetron and domperidone may also be useful.

How The Migraine Trust can help

If you have questions about vestibular migraine you can contact our Information service via our online form. Alternatively, you can call us on 0203 9510 150 (from 10am to 4pm on Tuesdays and Thursdays)

Recurrent vertigo associated with headaches

1. Georgios Kontorinis, consultant ear, nose, and throat surgeon and neurotologist1,
2. Alok Tyagi, consultant neurologist2,
3. John A Crowther, consultant ear, nose, and throat surgeon and neurotologist1

1. ¹Department of Otolaryngology, Queen Elizabeth University Hospital, Glasgow, UK
2. ²Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK

1. Correspondence to G Kontorinis gkontorinis{at}gmail.com

A 37 year old woman attended the otolaryngology department with episodes of dizziness (“a feeling of swaying”), occasional rotatory vertigo, and unilateral right sided headaches that usually occurred once a week and had been ongoing for six weeks. Her symptoms could last several hours and were sometimes preceded with the appearance of transient flashing lights. Some episodes were associated with short lasting blurred vision and occasional nausea. Her symptoms were unrelated to head or neck movements but could deteriorate with tiredness, bright light exposure, or high coffee consumption. They would improve after several hours if she could lie down in a dark room. The headaches would usually follow the dizziness/vertigo. There was catamenial exacerbation of her symptoms but no phonophobia, hearing problems, or tinnitus.

She had a history of similar episodes a few years ago that had gradually settled without medication.

Clinical examination was unremarkable. She underwent magnetic resonance imaging (MRI) of the brain and inner ear (fig 1).

Fig. 1

Axial fast imaging using steady state acquisition (FIESTA) MRI of the internal auditory meatus and the brain (A) with a focus on the internal auditory meatus (B) 

Fig. 2

No abnormalities seen on axial FIESTA-MRI. IAM: internal auditory meati. CPA: cerebellopontine angles bilaterally (no vestibular schwannoma). (1) White arrows point to the cochleovestibular nerves in the IAM. (2) Loop of the anterior-inferior cerebellar artery. (3) The labyrinth (in this section with the lateral semicircular canal). (4) Long dotted arrows show the cochlea. (5) White X marks the anterior end of …

90,000 causes and treatment. Why dizzy and how to get rid of it – health articles

Contents

Dizziness is not a disease, but a symptom that occurs in a number of a wide variety of diseases, causing the patient to disorientate in space, a false sensation of the mobility of objects and stationary objects relative to him or the person himself – relative to the objects around him. It is extremely common, especially among elderly patients and females – in terms of the frequency of medical complaints, it is in second place after headache.

The diagnosis of vertigo is difficult, since the sensation of instability in space is extremely subjective and can differ significantly in different patients both in the degree of manifestation and in the sensory phenomena that arise in this case.

The condition can arise suddenly, be of an episodic nature: the patient experiences something like a push to one side, as if he is being “led”.

Description

The condition can arise suddenly, be of an episodic nature: the patient experiences something like a push to one side, as if he is being “led”.In other cases, there may be a feeling of movement of surrounding objects in a circle or a feeling of rotation of the person himself, as after a long spin on a carousel. This state can persist for a long time – up to an hour. But more often, dizziness is expressed in a feeling of general instability of objects and the person himself, a violation of the sense of balance – the patient feels insecure when walking, it seems to him that he is about to fall or stumble, the ground “leaves” from under his feet. Sometimes the symptoms are so severe that the patient grasps objects and feels lightheaded, as before losing consciousness.

Dizziness can be accompanied by other symptoms, which depend both on the reasons that caused it (the underlying disease) and on the degree of manifestation.

Symptoms

Dizziness can be accompanied by other symptoms, which depend both on the reasons that caused it (the underlying disease) and on the degree of manifestation.

Systemic dizziness (vertigo) is characterized by:

• Feeling of rotation around its axis, or rotation of the environment around, a feeling of incorrect body position in space (with an inclination to one or the other side)
• Coldness of limbs
• Hyperhidrosis (excessive sweating), which can be localized in the limbs or affect the whole body
• Feeling of fear, lack of air
• Feeling of unnatural lightness in the head, lack of thoughts
• Numbness of lips, face and other harbingers of fainting, weakness, lightheadedness
• Nausea and vomiting
• Acceleration of pulse, increase in blood pressure
• Tinnitus, hearing loss
• Flickering “flies”, darkening in the eyes
• Nystagmus (involuntary twitching of the eyeballs)

Symptoms appear or intensify with a sharp change in body position, head rotation, bending / lifting, looking at moving objects, traveling in transport.

Causes of dizziness

The causes of this condition can be conditionally divided into physiological (normal) and pathological (as a result of a disease).

Physiological causes of dizziness.

Physiological causes of dizziness:

• Fast non-linear / abrupt movement (riding on attractions, jumping from a height)
• Fright (due to the action of stress hormones on the cardiovascular system)
• Hyperventilation of the lungs (oversaturation with oxygen – for example, as a result of scuba diving)
• Low iron levels with an unbalanced diet – lack of oxygen in the blood and tissues, including the brain
• Hypoglycemic conditions (with untimely nutrition or low-calorie diet) – depletion of the body’s energy supply
• Dizziness in women during or shortly before menstruation, during pregnancy

Pathological dizziness occurs when:

• Diseases of the inner ear (labyrinthitis, Meniere’s disease, vestibular neuritis), as a result of which not only perception, but also the conduction of auditory and vestibular impulses to the analyzer in the brain is impaired
• Osteochondrosis and hernia of the cervical spine – as a result of compression of the vessels of the neck and impaired blood supply to the brain
• Stroke, thrombosis, ischemia – when, as a result of an acute circulatory disorder, the brain experiences oxygen starvation (hypoxia)
• Migraines and BPPV (benign paroxysmal vertigo – paroxysmal, with head movements)
• Panic attacks
• Climacteric syndrome
• Brain tumors
• Taking certain medications

In total, there are about 80 diseases that cause vertigo, and only a comprehensive examination will help identify the cause and prescribe etiotropic treatment.

Dizziness. Diagnostics and treatment

Symptomatic treatment of dizziness is possible only after the doctor has established the cause that caused it and only in parallel with qualified treatment of the underlying disease. As a rule, it includes several components: taking medications, adherence to the daily regimen and physical activity, diet.

Symptomatic treatment of vertigo is possible only after the doctor has established the cause that caused it.

Drug therapy:

• In case of circulatory disorders, drug therapy will include the use of vasodilators and antihistamines and drugs that improve the rheological properties (fluidity) of the blood (cinnarizine, betahistine)
• Neurogenic dizziness requires taking nootropics (picamilon, gamma-aminobutyric acid), which not only improve blood circulation and nerve conduction
• Vertigo caused by osteochondrosis requires taking muscle relaxants to relieve muscle spasm
• In women, the treatment of dizziness caused by menopausal changes or irregularities in the cycle is carried out with hormonal drugs that allow the body to return the hormonal background to normal

Mode. Reduces to adherence to the daily routine, the correct alternation of mental and physical exertion, sleep and wakefulness.

Diet . Eliminates the use of foods that increase blood pressure and cause vasospasm, stimulating the nervous system (coffee, strong tea, alcohol, nicotine, very salty or spicy foods).

Folk remedies. Folk recipes include ginger root, parsley or fennel seeds, hawthorn infusion, etc.etc.

Not a single folk remedy should be used without prior agreement with the attending physician, since even the most harmless of them may have individual contraindications.

Gymnastics. To train the vestibular apparatus outside of an attack, it is recommended to do some exercises:

• Rotation of the head, trunk from side to side with closed and open eyes
• Swing on a swing with a gradual increase in amplitude
• Balance Exercises (Stand on one leg with eyes open and closed)
• Rotation of eyes in different directions
• Swimming

When should you see a doctor immediately?

• If dizziness occurs for the first time, accompanied by nausea, vomiting or headache
• Has resulted in loss of consciousness
• Weakness, tremors (tremors) of the extremities, tachycardia, sweating, feeling of shortness of breath, chest pain
• Lasts more than an hour
• If, together with dizziness, there is a sharp decrease in sensitivity or weakness in one half of the body, face or limb

These symptoms indicate a possible development of an emergency and require urgent medical attention.

If vertigo attacks occur intermittently and the cause is known, you can relieve the symptoms yourself.

Home treatment for vertigo

If vertigo attacks occur intermittently and the cause is known, you can relieve the symptoms yourself using the following techniques:

• If your head is dizzy after getting up suddenly, tilt your head forward and exhale completely
• In a sitting position – bend over to the knees, maintain the position until symptoms stop
• Take a stable position (sitting with your feet apart, rest on the floor) and focus your gaze on one point on a stationary object
• Splash cold water on your face
• Inhale ammonia vapors
• Drink some hot sweet tea
• In the future, be careful when changing the position of the body: slowly lie down, bend over and get up

Advantages of the procedure in MEDSI:

• Treatment of dizziness in Moscow in a convenient place at a convenient time – a wide network of clinics allows you to find a suitable branch in your area
• Availability of hardware enabling complete diagnostics of vertigo
• Assisting with dizziness emergencies
• Reception is carried out by qualified specialists with experience – doctors of the highest and first category
• High rating of the clinic while maintaining the average cost of services for Moscow

Dizziness treatment in Moscow in a convenient place at a convenient time – a wide network of clinics allows you to find a suitable branch in your area

To make an appointment, call the round-the-clock phone: 8 (495) 023-60-84

Our doctors

Head of the Neurology Center, doctor MEDSI Premuim

Doctor of Medical Sciences, Professor, Doctor of the highest qualification category

Head of the Center for Neurology, Vertebrology and Psychosomatics, neurologist

Head of the Department of Neurology, Psychotherapy, Psychiatrist, Psychotherapist

Candidate of Medical Sciences, Doctor of the highest qualification category

Neurologist

• Diagnostics and treatment of insomnia
• Diagnosis and treatment of sleep apnea
• Treatment of anxiety disorders

Dizziness and headache – a: care

Severe headache can disrupt normal life. It does not allow us to enjoy the best moments, from which the happiest memories should have formed. Headaches not only alter our perceptions, but also impair our ability to concentrate, impair memory, and negatively affect work performance and relationships with colleagues. [1] [2]

Headache in scientific language is called cephalalgia. It is usually divided into three categories:

• tension headache (HDN) is pain caused by muscle tension;
• migraine – a severe headache with a very complex mechanism of development;
• Headache caused by a disease.[3]

Most often, the headache is due to the tension of the pericranial muscles. [4] HDN accounts for 80-90% of all headache cases. [3] It can occur, for example, if you overwork in the gym or sit for a long time at the dentist in an uncomfortable position.

Migraine affects approximately 20% of the population. [1] At the same time, women have it 3-4 times more often than men. [1] [5]

Sometimes, before the onset of a migraine, a person feels her approach, the so-called “aura”.Its symptoms are nausea, dizziness, weakness, tinnitus, etc. [6] Recent studies have found that a person’s predisposition to migraine depends on the presence or absence of certain genes. [7]

The main difference between HDN and migraine is that tension headache arises and develops gradually, and a migraine attack – almost always suddenly and in the presence of other symptoms. There is also a mixed headache, in which there are signs of both migraine and HDN.[3]

A headache in itself can greatly complicate a person’s life, but it is often accompanied by other unpleasant symptoms, such as dizziness.

Unlike headache, dizziness is always a symptom of some other disease or condition, but a headache can also be an “alarming signal” of the body.

What diseases contribute to dizziness or headache? [8]

Most often it is:

• head trauma,
• cervical osteochondrosis,
• vegetative-vascular dystonia,
• hypertension,
• brain tumor,
• meningitis,
• stroke,
• flu or cold,
• concussion,
• eye diseases,
• diseases of the inner ear, etc.

Both dizziness and headache can be psychogenic in nature, i.e. arise from emotional distress. [3]

Treatment of dizziness and headache

To cure dizziness and headache, it is necessary, first of all, to find out the cause that causes them. This can only be done by a specialist. In addition to drug therapy, diet and prevention of dizziness are important for the success of treatment. They include good rest, smoking and alcohol cessation, special gymnastics and, if necessary, psychological assistance.Some medications can also provoke a headache, so it is unsafe to self-medicate, it is much better to see a doctor right away. [1]

Be attentive to your health and remember that any disease is much easier to cure at an early stage!

List of used literature:

1. Vorobieva OV Treatment of migraine headache // Nervous diseases. – 2014. – No. 2. – S. 2-5.

2. Kuznetsova EA, Yakupov EZ Changes in cognitive evoked potentials (p300) in chronic daily headaches // Kazan Medical Journal.- 2011. – T. 92. – No. 1. – S. 17-19.

3. Zelenkina S. Massage for migraines. M .: Veche, 2003 .– 205 p. – https://www.e-reading.club/chapter.php/69012/3/Zelenkina_-_Massazh_pri_migreni.html (Access date: 25.06.2016).

4. Tabeeva GR, Azimova Yu. E. New in the treatment of episodic tension headache // Neurology, neuropsychiatry, psychosomatics. – 2010. – No. 4 – S. 57-62.

5. Amal Mattu; Deepi Goyal; Barrett, Jeffrey W .; Joshua Broder; DeAngelis, Michael; Peter Deblieux; Gus M.Garmel; Richard Harrigan; David Karras; Anita L’Italien; David Manthey. Emergency medicine: avoiding the pitfalls and improving the outcomes. – Malden, Mass: Blackwell Pub./BMJ Books, 2007. – P. 39.

6. Zamergrad MV Vestibular disorders in neurological and general medical practice // Modern therapy in psychiatry and neurology. – 2012. – No. 2. – S. 20-26.

7. Piane, M; Lulli, P; Farinelli, I; Simeoni, S; De Filippis, S; Patacchioli, FR; Martelletti, P (December 2007). Genetics of migraine and pharmacogenomics: some considerations. The journal of headache and pain 8 (6): 334-9.

8. Morris Levin, Steven M. Baskin, Marcelo E. Bigal. Comprehensive Review of Headache Medicine. – Oxford University Press US, 2008. – P. 60.

Co-author, editor and medical expert:

Volobueva Irina Vladimirovna

Born on September 17, 1992.

Education:

2015- Sumy State University, specialization “General Medicine”.

2017 – Graduated from an internship in the specialty “Family Medicine” and also defended her master’s work on the topic “Features of the development of antibiotic-associated diarrhea in children of different age groups.”

90,000 Dizziness, headache – signs of vascular aging

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Collecting together the data of medical practice, the world’s luminaries in the field of medicine are increasingly declaring: “old age is getting younger”

And, although many perceive the phrase as a good pun, the meaning of the enigmatic maxim is rather sad.Based on the collected statistics, the first signs of old age appear at the age of 35, which is 15 years less than at the end of the 20th century.

Among the first signs of aging, doctors note dizziness, high fatigue and absent-mindedness – symptoms of oxygen starvation of brain cells. It is believed that forgetting and not noticing elementary things is peculiar to older people, and yesterday’s students only smile at the request of their grandmother to find glasses or a key. Indeed, dizziness and distraction often accompany degenerative changes in brain cells caused by impaired blood supply.Aging of blood vessels, which causes such phenomena, can begin at 35, and even earlier.

Nobody wants to grow old, so many people ignore dizziness and blackheads before their eyes, preferring to keep a diary as a panacea for forgetfulness. Unfortunately, this approach does not restore oxygen supply to the brain tissue, and cell hypoxia gradually leads to an increase in the symptoms of aging. In response to stress, alcohol and nicotine poisoning, chronic lack of sleep, a headache appears, bouts of lightheadedness in transport, and sometimes panic attacks occur.

In an effort to “cure everything with one pill”, many begin to buy “miraculous drugs” that can stop unpleasant symptoms. And only a few turn to a doctor in order to stop the premature aging of blood vessels in order to avoid problems such as Parkinson’s disease, dementia, and prevent coronary artery disease, cerebral atherosclerosis and other unpleasant consequences of impaired cerebral circulation. Meanwhile, it is quite possible to stop the aging of blood vessels at the initial stage.

Sholomov Ilya Ivanovich, neurologist, head of the Department of Nervous Diseases, S.S.M. IN AND. Razumovsky, Doctor of Medical Sciences, Professor:

“Dizziness and headache may be the first signs of problems with the vessels of the brain. Cerebral circulation disorders can be promoted by: increased blood pressure, stress, diseases of the spine, trauma. Of course, many people greatly overload the work schedule, and the lack of normal sleep, combined with emotional shocks, does not go unnoticed.Headaches, dizziness, memory loss during severe stress are a natural consequence of a busy lifestyle. As practice shows, massage and emergency medical care help to solve the problem “here and now”, however, without constant prophylaxis, attacks of dizziness can become more frequent. To improve cerebral circulation and increase the resistance of brain tissues to hypoxia, which is inevitable in case of impaired blood supply, doctors use a number of drugs, including Vasobral, which provide quick recovery of working capacity, improve metabolic processes in brain cells, thanks to the components that make up their composition.With regular use, there is a decrease in the permeability of the vascular walls, a decrease in the risk of vascular obstruction. The uniqueness of the action makes it possible to achieve a decrease in the frequency and severity of dizziness attacks, and provides a prophylactic effect in case of migraine.

Along with drug therapy, it is customary to prescribe special diets and various restrictions. Of course, quitting smoking and alcohol will significantly improve the condition of the blood vessels, but you can start with simpler steps. For example,

1.Drink clean water every time you are thirsty. Dehydration often leads to dizziness, and metabolic processes slow down with a lack of fluid.
2. Sleep every day, in the dark, cool, with good ventilation and minimal noise. So the body will better rest and recover faster.
3. Add foods rich in calcium, magnesium, vitamin E to your menu: green vegetables, cheeses, nuts, vegetable oils.
4. Move as often as possible, more and more varied.Walking backwards along the corridor, jumping on one leg, joining your palms behind your back – any unusual activity will improve blood circulation.

Thus, even small changes in lifestyle and taking medications can avoid disturbances in the blood supply to brain cells and early degenerative changes.

90,000 Constantly headache – what to do?

Headache (cephalalgia) is an extremely common condition, familiar to almost 90% of the population.It is important to know that headache is not an independent disease, but a serious symptom indicating internal, including rather serious, disorders. If the pain is temporary, rarely manifests itself, quickly passes and is easily stopped with the help of an analgesic, do not worry. However, persistent, frequent and intense headaches can be a sign of a serious illness and a reason to see a doctor. A comprehensive examination, a specialist consultation will help to identify the cause, prescribe the appropriate treatment, and receive valuable advice on lifestyle.

Types of disease

Periodic or persistent headaches can manifest as a reaction of the body to physiological or psychophysiological changes in the structures of the brain, vascular disorders, disturbances in the tone of the muscles of the neck or skull. In neurology, several types of cephalalgia are distinguished, each of which has its own characteristics, character, localization and intensity:

• Migraine – a sharp and severe headache, often of a pulsating nature. It is accompanied by nausea, intolerance to light and strong odors.Painful sensations are often one-sided, extending to the lower jaw, cervical muscles. The attack can last from several minutes to several hours, appears in the evening. Migraine mainly affects women between 25 and 35 years old.
• Stress pain is the most common, occurs with the same frequency in women and men. By nature, pressing or squeezing, can cover the entire head or only the back of the head, forehead, crown. Often appears after physical or mental strain, stress, lack of sleep, prolonged work at the computer.It stops well with analgesics or goes away on its own after rest or sleep.
• Cluster (Hortonian) – one of the most severe types of headache, which can disturb a person with prolonged attacks of a pulsating nature. Mostly unilateral, radiates to the eye area, temple. The attacks last from 20 minutes to several hours, then subside and repeat again.
• Post-traumatic – develops with a bruise or concussion. The intensity depends on the nature of the injury and the degree of damage to the structures of the skull.

There are many reasons for frequent headaches, you should not look for the source of pain on your own, you should consult a neurologist. According to medical observations, the main cause of persistent headaches is vascular disease. These include vegetative-vascular dystonia, hypertension, ischemia, subarachnoid hemorrhages, stroke and other life-threatening conditions. A pulsating character may indicate an impending stroke, supplemented by dizziness, impaired consciousness, heart palpitations and other pronounced signs.Localized in the back of the head, frontal part, accompanied by tinnitus, “goosebumps”, nausea, discomfort behind the sternum. Disappears after stabilization of blood pressure. Dangerous headache, usually “pressing” or “bursting”, developing against the background of increased intracranial pressure. It can be caused by malignant or benign brain tumors, traumatic brain injury. In addition to severe pain, patients feel nausea, vomiting, dizziness.

Main causes of headache

The etiology of headache directly depends on the underlying cause.This symptom is characteristic of many pathologies, but mainly develops against the background of the following diseases and conditions:

• hypertension;

90,023 migraine;

• increased intracranial pressure;
• osteochondrosis of the cervical spine;
• chronic stress, psychosomatic disorders;

90,023 infectious diseases;

• poisoning by toxic or poisonous substances;

90,023 trauma to the brain or spine;

• any intoxication of the body;
• occipital neuralgia;
• tumors;
• hormonal imbalance.

Persistent headaches can appear not only against the background of diseases, but also be the result of an improper lifestyle. The provoking factors include:

• weather dependence;
• stress, depression;
• disturbed diet;
• fasting, diets;
• overwork;
• physical and mental stress;

90,023 smoking;

90,023 dental diseases;

• alcohol abuse.
• taking strong drugs.

Any changes in the body can cause an attack of cephalalgia, but if it is poorly controlled by analgesics, you do not need to hesitate to visit a doctor, who, after a history and examination results, will make the correct diagnosis and prescribe the necessary treatment.

Diagnostics

To determine why the head hurts constantly, you should contact the neurologist . After collecting anamnesis, visual examination and studying the patient’s medical history, the specialist will prescribe a number of examinations:

• Electroencephalography (EEG) – evaluates the work of the brain, reveals vascular pathologies, hematomas, tumors.
• X-ray – detects trauma, sinusitis, sinusitis and other changes in the area of ​​the skull.
• MRI is an informative examination method that allows you to evaluate the work of the brain with an accuracy of up to 98%, to reveal the slightest changes in its work. It is prescribed for vascular diseases, suspected brain tumors.
• CT – detects changes in brain structures, detects tumors, cysts, injuries, thrombosis and other pathologies.
• Ultrasound – diagnoses pathologies and abnormalities of blood vessels, blood flow disturbances.
• Laboratory methods – detect infectious processes in the body, autoimmune disorders, determine the level of cholesterol in blood plasma and other important indicators.

The obtained examination results allow the doctor to obtain a complete clinical picture, make the correct diagnosis, and prescribe the necessary treatment. Persistent headaches cannot be ignored, early diagnosis and correct therapy will help eliminate serious consequences.

First aid

Pain in the head can appear at the most inopportune moment. How to help a person, especially if there are no painkillers on hand.

• Provide complete rest. Eliminate all sorts of annoying factors, muffle sounds, lie down, close your eyes and try to relax.
• Light head massage.
• Do not overload the body – exclude smoking and alcohol consumption, physical and mental stress.
• Place a flat pillow under your head.
• Drink moderate pain relievers. It is not recommended to take strong drugs or those drugs that have not been previously taken.
• Measure the pressure. With increased rates, take an antihypertensive drug.
• You can put a cold compress on your forehead for 10-15 minutes.

In more severe cases, you need to call an ambulance or take a person to a hospital.If, with constant headaches, the examination does not reveal the disease, you should pay attention to the lifestyle. This symptom often affects people who experience chronic fatigue, do not sleep enough, sit on “hungry” diets, smoke a lot, abuse alcohol or have a tendency to depressive conditions. In this case, doctors recommend changing the daily routine, paying more attention to your health, rest and nutrition.

Treatment methods

In case of persistent headaches, you cannot do without competent advice from a neurologist.Treatment will directly depend on the underlying cause. To relieve pain, a wide range of medications are recommended, including analgesics, anti-inflammatory, vasodilator, antispasmodic, anticonvulsant drugs. It is extremely important, at the same time, not to self-medicate, only a doctor can prescribe the correct therapy, the time and frequency of taking medications. Persistent headaches are a sign of internal diseases, so the doctor, when making a diagnosis, will prescribe other medications in accordance with the diagnosis.As an auxiliary therapy, the following can be prescribed:

• acupuncture;
• osteopathy;
• physiotherapy;
• physiotherapy exercises;
• Methods of extracorporeal hemocorrection.

An integrated approach to treatment will help speed up recovery, eliminate unpleasant symptoms, and improve the quality of human life.

Prevention

The following recommendations will help reduce the risk of developing persistent headaches:

• Correct and healthy nutrition.
• Adequate sleep and rest, at least 8 hours.
• Airing the room before going to bed.
• Elimination of stress, depression.
• Elimination of physical and mental fatigue.
• Regular blood pressure measurement.
• Combating dehydration.
• Walking in the fresh air.
• Smoking and alcohol cessation.

Compliance with basic rules will help not only reduce the likelihood of headaches, but also minimize the development of other diseases. It is important to understand that such a symptom can bother almost every adult, but if your head hurts constantly, you should not self-medicate. A timely visit to a neurologist will help solve the problem, eliminate serious consequences.

Neurologist

Neurologist of the highest qualification category

90,000 Headache in vascular diseases / Articles / “Avicenna” in Volgograd

07/06/19

There is probably not a single adult who does not have a headache.There are also many children suffering from headaches. Headache is most often manifested in such common diseases as hypertension, cerebrovascular disease (atherosclerosis, congenital vascular disease), migraine, etc. Headache is a manifestation of various changes in the brain, including its membranes and blood vessels, and always requires special studies to establish the causes of its occurrence.

Headache in vascular diseases

Sometimes, by the nature and location of the headache, you can determine its cause.Pain in the occipital region of the head is most often caused by an increase in blood pressure or a disease of the spine. Pain in one half of the head is more common with migraines, and the frontal part of the head is observed in diseases of the paranasal sinuses and organs of vision. Morning headaches are often associated with increased intracranial pressure. The appearance of headaches at the end of the working day is often associated with overwork. Let’s talk about vascular diseases as the cause of headaches.

In case of ineffective treatment of headache, think about whether you have diseases of the great vessels that feed the brain.These include: atherosclerosis, tortuosity (up to loop formation), aneurysm, and others.

In healthy people, blood flows freely through the arteries to all organs and tissues, supplying them with oxygen and other nutrients. In atherosclerosis, a fatty substance – cholesterol – is deposited on the inner wall of the arteries. A “build-up” is formed on the inner wall of the vessel – an atherosclerotic plaque, narrowing the lumen of the vessel and disrupting the blood flow in the organ. Oxygen starvation of the organ develops, which receives blood from the affected artery.With atherosclerosis, the arteries of the heart are also affected – chronic ischemic heart disease develops (its clinical manifestation can be chest pain, arrhythmias, heart failure). As a rule, the provocative moment of this condition is a headache. With a pronounced narrowing of the vessel that feeds the brain, there is a chronic insufficiency of the blood supply to the brain. Its outcome is a stroke. Stroke is the second most common “killer” of people.

A characteristic feature of headache with vascular lesions is its persistence.Headaches with lesions of cerebral vessels are often accompanied by dizziness, memory loss, gait instability, the appearance of dark “flies” in the eyes, numbness of the extremities, fatigue, nervousness, poor sleep, noise in the head. Risk factors for the development of atherosclerosis include: high blood pressure, stressful lifestyle, physical inactivity, smoking, obesity, diabetes mellitus, heredity.

If you are tormented by a headache, you suffer from atherosclerosis, hypertension, there are the above risk factors, if you value your health, if you do not want the sad statistics of stroke victims to be replenished at your expense – act now! Stroke is easier to prevent than to cure! Today, medicine is ready to successfully fight the pathology of the great vessels.

Visit a neurologist, cardiologist, ophthalmologist! After a conversation with you and a medical examination, the doctor will prescribe the necessary diagnostic, therapeutic and preventive measures, and then refer you to a vascular surgeon. The main method for diagnosing vascular diseases that feed the brain is ultrasound diagnostics (ultrasound of the neck vessels), which can be used to detect vascular lesions. The huge advantage of this diagnosis is its accuracy and the possibility of performing it on an outpatient basis.In addition, ultrasound diagnostics provides information about the lesion of the aorta, the main arteries, even in cases where there are no clinical signs of a particular disease. This diagnostic method is especially indispensable in identifying congenital vascular pathology in children, and they also have a headache.

Along with ultrasound diagnostic methods, there are now other methods of detecting vascular lesions. These are magnetic resonance angiography, electron beam tomography and a number of others.But all of them are based on the use of expensive devices and cannot be applied on a mass scale.
The unclear cause of the headache, the abundance in the media of advertisements for drugs and dietary supplements with instructions for their use, home physiotherapy devices – all this postpones the time of the patient’s visit to the vascular surgeon with already obvious signs of the disease. As a result, doctors continue to treat, patients continue to get sick.
Knowing the cause of your suffering associated with vascular disease, you can turn to a vascular surgeon in time, get the opportunity to restore normal patency of the vascular bed, get rid of a headache, and prevent a formidable complication – a stroke.

Today Along with the development of new diagnostic techniques, improvement of surgical techniques, including endovascular (intravascular), methods of protecting the brain from ischemia, indications for surgical treatment have been clarified. The question of indications for surgical treatment is decided only by the vascular surgeon, taking into account the patient’s examination data from other specialists (neurologist, cardiologist).

I hope that together we will try to solve the problem of headache in vascular diseases.

90,000 Headache

Headache is one of the most common complaints of patients. There are a great many reasons for headaches: changes in blood pressure; inflammation, trauma and brain tumors; neuralgia; autonomic dysfunction; solar and thermal shock; intoxication and much more. In some diseases, for example, migraine , intense headache is the main manifestation of the disease. The headache can be long-lasting and aching or sharp and unbearable, it can cover the entire head or be felt only in the temples.

Reasons .

Aching bilateral headache often accompanies arterial hypotension . Typically, this headache appears after sleep in the morning and is felt in the temporal regions. Headache with physical exertion, the use of drinks containing caffeine, such as tea or coffee, disappears.

Contrary to popular belief, hypertension rarely causes headaches if the pressure is constantly increased.But if it rises sharply, most people feel a headache and tinnitus, combined with the flickering of flies in front of their eyes, a feeling of tightness in the back of the head, pounding in the temples and dizziness. This condition must be taken seriously, it can become a sign of a developing hypertensive crisis . A crisis, in turn, can lead to complications: stroke and myocardial infarction. Psychogenic headache . Under this name, headaches from mental or physical stress are combined, as well as pain in anxiety and depression.In such conditions, it can be difficult to describe the nature of the pain – it can turn out to be aching, then pressing, then concentrated in the occipital, temporal or frontal regions, or spread throughout the head. Diagnosis and treatment of headaches is individual for each patient and often requires the involvement of specialists in medical psychology and neuropsychiatry. Headache is the main and often the only manifestation of migraine – a disease associated with impaired cerebral vascular tone. Women are more likely to suffer from migraine: the first attacks begin between the ages of 10 and 30. With classical migraine , an aura first appears in the form of blurred vision, clouding of objects, etc. Then a one-sided throbbing headache develops, which can be given to the eye and be accompanied by nausea, vomiting, sound and photophobia.

There are many other forms of migraine . With them, pain can begin without an aura, be accompanied by neurological disorders, appear in the face, be sudden, short-term and intense.Sometimes attacks can follow one after another for several days, accompanied by nausea and vomiting. This condition is called migraine status . Hortonian (histamine) headache is manifested by periodic short (15 minutes – 2 hours) attacks. Typically, these headaches occur late at night or early in the morning. The pain is extremely strong, burning, boring, piercing; appears suddenly and is usually concentrated on one side in the orbit. During an attack, the patient can neither lie nor sit, but walks around the room (in contrast to patients with migraines who try to find a dark, quiet place and fall asleep).As a rule, seizures occur daily for several weeks or even months, after which they disappear for years. Most often, Hortonian headache affects men over 20 years old. If a severe headache occurs simultaneously with a fever, this may signal the onset of meningitis – an inflammation of the meninges. With meningitis, the headache is severe, may be pressing on the eyes, accompanied by nausea and vomiting. At the same time, other manifestations of meningitis occur – for example, it is impossible to touch the chest with the chin, and disturbances of consciousness may occur.On the other hand, a high fever itself causes a headache, which, however, disappears after taking aspirin or paracetamol. Sudden severe headache (often with loss of consciousness or loss of sensation in any area of ​​the body) occurs with a brain hemorrhage (hemorrhagic stroke). As a rule, it occurs with an increase in blood pressure and cerebral atherosclerosis. If headache attacks started out of the blue and quickly became regular and intense, do not postpone a visit to a neurologist – such pain is often the first manifestation of a brain tumor .Often the pain is accompanied by nausea, dizziness, double vision. Similar pain can also be observed with hematoma (accumulation of blood) under the meninges or with abscess (suppuration) of the brain. The cause of headache may be cervical osteochondrosis , spondyloarthritis , sciatica and other diseases of this spine are often accompanied by headache. The cause of pain in the frontal and temporal regions can be inflammation of the paranasal sinuses – for example, sinusitis or frontal sinusitis.At otitis media headaches seize the parotid space, can be very strong and sharp (“shoots in the ear”). An increase in headache against the background of otitis media or its spread to other parts of the head, simultaneously with the occurrence of nausea and vomiting, may be a sign of the spread of the infection and requires immediate medical attention. Headache and facial sensation become a manifestation of neuralgia of the trigeminal or facial nerves . Headache can also be “masked” diseases of the joints of the lower jaw .

Another type of headache – toxic . It occurs when poisoning with various chemicals or as a side effect of taking medications. For example, headaches are often caused by drugs that lower blood pressure, nitrates, psychotropic drugs, and many other substances. A particular case of toxic headache is the popular hangover ; with it, the head hurts due to the effects of acetaldehyde, a toxic decay product of ethyl alcohol.A spilled headache can occur in a completely healthy person in a stuffy room (due to a banal lack of oxygen for the brain). It can be caused by carbon monoxide, car exhausts, fumes from drying paint, and simply harsh odors, even pleasant ones. Severe headache accompanies sunstroke and heatstroke.

90,000 Articles

Even a small portion of alcohol can cause headaches in 80% of people. Why and how to escape from this headache, our neurologist Daria Zakharovna Korobkova told.

📎 What is this headache

This is pain that develops within 3 hours after drinking alcohol and disappears within 72 hours after you stop drinking. She has at least one of the characteristics:

– double-sided;

– pulsating;

– aggravated by physical activity;

– or it can be pressing in nature and localized in the frontal region.

Headache that develops immediately after drinking alcohol is less common than hangover headache (which begins when blood alcohol levels drop).

The intensity of the pain depends on the quantity and quality of the drink, as well as on the individual characteristics of the person.

And alcohol often triggers an attack of migraine or cluster headache if a person suffers from these diseases. In this case, attacks can only be caused by certain drinks. For example, red wine can provoke, but cognac – does not. This moment is purely individual: therefore, try to identify your alcohol provocateur with the help of a diary and refuse it.

📎 What is causing this headache. A bit of science.

Its mechanism, oddly enough, is not fully understood. But there are probably several factors at work:

▪️ Alcohol acts on the central nervous system and cerebral vessels

It is believed that alcohol can dilate the vessels of the lining of the brain, which can manifest itself as a headache. In addition, it is believed that it acts on the pain system of the brain. It is known that alcohol has a short-term analgesic property, but after its cancellation (especially when a significant amount is consumed), the so-called hyperalgesia occurs – an increased sensitivity of the body to pain stimuli.

▪️ Dewatering

Alcohol has diuretic properties: along with urine, fluid is removed from the body, the amount of blood decreases and the blood flow rate slows down, it becomes difficult to remove carbon dioxide. Vomiting and diarrhea with alcohol intoxication also lead to dehydration.

▪️ Intoxication

Acetaldehyde is a breakdown product of ethanol that occurs in the human body. When there is a lot of it, it has a toxic effect on brain cells, disrupting the work of neurotransmitters and altering the electrical activity of neurons.

▪️ Disturbed sleep

Alcohol negatively affects the phase of REM sleep, during which the brain processes and stores the information received and synthesizes various proteins involved in important brain processes.

What else: dark alcoholic beverages (whiskey, cognac, brandy) contain significantly more congeners – of other toxic chemical compounds other than ethanol (these are acetone, tannins, fusel oils, methanol), which are by-products of fermentation.Therefore, it is believed that the risk of a hangover headache from dark drinks is higher.

📎 What to do with a hangover headache?

The classic headache following alcohol consumption usually resolves on its own within 72 hours. What else can help:

✅ sleeping in a cool room or walking in the fresh air;

✅ dehydration compensation: preference to give water without gas, and then drink tea or coffee. Better yet, drink two glasses (but no more) of sodium-magnesium mineral water – it replenishes the electrolyte deficiency after drinking alcohol;

✅ light snack (toast and a glass of juice, honey).Alcohol helps to lower blood glucose levels, and a light snack will replenish it;

✅ analgesics: aspirin, ibuprofen and other non-steroidal anti-inflammatory drugs. But not paracetamol – if alcohol and its metabolites have not yet been excreted from the body, taking paracetamol can increase their toxic effects on the liver.