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Understanding Head Pressure and Dizziness

Understanding Head Pressure and Dizziness

There can be many reasons why head pressure and dizziness can co-exist. Some are easily managed, except in rare cases when symptoms might indicate a medical emergency.

For example, if a person complains that their head throbs, feels as though it is full, and even the slightest movement causes them to feel dizzy, it could be a migraine. But, their symptoms might result from any number of medical conditions that can cause the sensation of tightness or pressure in the head or behind the eyes, dizziness, and headaches.

While these feelings can range from mild to severe, in most cases, the reason behind head pressure is not a reason for alarm, although seeking a medical diagnosis is advisable. However, any chronic or severe and sudden symptoms warrant seeing a healthcare provider right away as they may be a warning of a serious underlying condition.

Common conditions include migraines, allergies, sinusitis, ear infections, tension headaches, high or low blood pressure (BP), psychiatric disorders, vitamin B-12 deficiency, and medication side effects.

Since these disorders can be caused by a person’s heart, ear, or brain, it can take time for a doctor to nail down the exact cause. Therefore, to assist a healthcare professional, not only should a person learn more about dizziness and head pressure, but they should pay attention to their body and symptoms.

Using a symptoms diary, track when dizziness occurs or worsens, triggers, and note any other symptoms such as headache or changes to hearing or vision. VeDA offers a free weekly log that includes a more extended checklist of symptoms. Patients paying attention to dizziness and head pressure symptoms make a doctor’s appointment more effective.

What it Means to Be Dizzy

“Dizziness could either be a sensation of feeling lightheaded and unsteady, or a sensation of abnormal movement of your body,” according to Dr. Roderick C. Spears, Penn Medicine’s Department of Neurology. Vertigo “is a spinning sensation of your body, or the perception of the environment around you moving when you’re not actually moving,” he added.

While Dr. Spears mentions vertigo, it is essential to know that there are four types of dizziness and how they differ:

  1. Vertigo: A person encounters a sense that they are moving when they are not or feels like they or the inside of the head is spinning, according to Medical News Today.
    • Vertigo is not an illness but a symptom of an underlying condition. It can affect a person temporarily or long-term.
    • One of the leading causes of vertigo is benign paroxysmal positional vertigo (BPPV), which is usually triggered by specific positional head changes.
    • Vertigo can make people so unsteady that they cannot drive or walk.
    • BPPV can happen with the little crystals in the ear become dislodged.
    • BPPV typically affects people ages 50 and older. However, it can strike at any age and is more common in women than men.
    • About one-third of patients with BPPV reported headaches.
    • People often mistakenly call the fear of heights vertigo. In reality, the fear of heights is acrophobia.
  2. Disequilibrium: A person feels unsteady (wobbly), off balance, and loses equilibrium, often accompanied by spatial disorientation.
  3. Pre-syncope: A person experiences a sensation that they will faint or pass out but do not. They might feel lightheaded, weak, confused, have blurry or tunnel vision, slurred speech, difficulty hearing, sweating, and nausea or vomiting. Note: Syncope refers to a person regaining consciousness after passing out.
  4. Lightheadedness: A person feels faint or disoriented. Lightheadedness results from “low blood pressure, lack of blood flow, or lack of blood flow reaching the brain,” explained Dr. Spears. Lightheadedness and vertigo can occur simultaneously.
Ways to ease dizziness during an attack:
  • Breathe slowly and deeply. When a person pays attention to their breathing — in through the nose and out from the nose — and counts each breath, their breathing will likely slow down, and their carbon dioxide levels will return to normal.
  • Close your eyes if it is safe. When someone closes their eyes, it removes the sensory input of the room spinning. Doing so “should ease some of your dizziness and reduce the chance of nausea and vomiting,” according to Calm Clinic.
  • Drink water. Try drinking water; this is especially important for people whose dizziness is connected to dehydration.
  • Focus on a spot. During a bout of dizziness, focus on a spot in the distance to reduce the spinning feeling. When it is impossible to choose one spot, place something like an index finger on the bridge of the nose to help reduce nystagmus or uncontrollable eye movement where the eyes rapidly move from side to side, up and down, or in a circle. This causes the eyes to try focusing on the finger, which could calm the rapid eye movement, according to Jodie Miyamoto, a physical therapist at Legacy PT in Oregon.

Potential Causes of Dizziness and Headache

Migraine: Vertigo or dizziness with a headache may signify a vestibular migraine, which can happen during any migraine phase. According to the Oxford Dictionary, Vestibular relates to a person’s inner ear or sense of balance.

Loretta Mueller, DO, a headache and neurology specialist at Cooper University Health Care, explained that dizziness is a common migraine symptom. “When people complain of dizziness, it’s migraine related about 50% of the time,” she added. Other symptoms such as nausea and light or sound sensitivity.

Brain fog seems to be specific to vestibular migraine. Dr. Spears said, “People will often describe a sensation of cognitive clouding or brain fog around these episodes.”

Sometimes vestibular migraine is not accompanied by a headache. However, if it does, it is not very severe. Dr. Spears explained that most of the patients he sees with vestibular migraine are more worried about vertigo than head pain.

Head Trauma: Headaches are common among people with a traumatic brain injury (TBI); they are often accompanied by dizziness. An estimated 30 to 65% of TBI patients report balance issues during their recovery, including dizziness and disequilibrium, according to Everyday Health.

In some cases, head trauma, ear trauma, or sudden barometric pressure change causes fluids in the inner ear to leak into the air-filled middle ear, a perilymph fistula. As a result, people experience ear fullness, headaches, episodes of unsteadiness, dizziness without true vertigo, nausea, fluctuating or sensitive hearing, motion intolerance, and tinnitus or ringing in the ears. Head trauma, such as a direct impact or a whiplash injury, is a common fistula cause, according to VeDA.

Low Blood Sugar: Hypoglycemia or low blood sugar could cause headaches and dizziness; it is usually accompanied by hunger, seating, and trembling, according to Everyday Health. Symptoms are likely to appear several hours after eating or exercising without adequate food consumption beforehand.

Patients with diabetes can experience low blood sugar by taking too much insulin or diabetes medication. In addition, drinking alcohol, missing meals, and increasing physical activity without adjusting to medication or food intake can lower a diabetic’s blood sugar.

High Blood Pressure (BP): People with hypertension, especially a sudden change in BP, may experience head pressure and dizziness.

Patients find that managing stress and reducing sodium and caffeine intake can help decrease hypertension. In addition, they should pay attention and record their blood pressure between doctor’s appointments using a home BP monitor.

If a person’s systolic (top) number exceeds 180 or their diastolic (bottom) number exceeds 120, immediately call emergency medical transport services or go to an emergency room.

Intracranial Hypertension (IH) is a build-up of pressure around a person’s brain. It can be a sudden (acute IH) or a persistent, long-lasting problem (chronic IH).

Acute intracranial hypertension is often due to a severe head injury, stroke, brain abscess, infection, or growth like a brain tumor. Life-threatening symptoms like a chronic throbbing headache or neurological problems such as dizziness and difficulty concentrating warrant promptly contacting a healthcare professional.

Chronic intracranial hypertension develops in some people for no apparent reason; it is idiopathic. Lifestyle changes often help to ease symptoms of feeling and being sick, fatigue, irritability, headache, and temporary vision loss.

Migrainous Stroke or Infarction: If a person experiences the sudden onset of dizziness with a headache, they could have a migrainous stroke; an ischemic stroke happening simultaneously with a migraine episode.

Ischemic infarctions happen when vessels pumping blood to the brain are blocked. Although seven out of eight strokes are ischemic, migrainous strokes are rare; they account for only 0.8% of all strokes. In a migrainous infarction, the migraine must occur with an aura, such as visual, speech, sensory, and motor disturbances.

While the connection between migraine and stroke is not fully understood, researchers found an increased stroke risk in migraine sufferers with aura symptoms.

Signs of an ischemic stroke include numbness or weakness of the face (particularly on one side), confusion, trouble speaking or seeing, difficulty walking, dizziness, and loss of balance or coordination, along with a severe headache and no known cause.

Anyone with stroke symptoms must seek emergency medical care.

When to See a Doctor for Dizziness and Head Pressure

Since dizziness and head pressure stem from brain, eye, or heart disorders, seeing a doctor is advisable. However, according to Medical News Today, a person should contact a physician if they have any of the following:

  • An ear infection or ear pain that does not improve in a few days or if it worsens.
  • A headache lasting longer than three days or suffering from frequent headaches.
  • Have severe allergies.
  • Think they might have migraine headaches.
  • Headaches that interfere with daily functioning or mental health.

Instead of worrying or self-diagnosing, visit a primary health care provider for a diagnosis and treatment.

Medical News Today: What might cause head pressure and dizziness? By Zawn Villines, Medically reviewed by Meredith Goodwin, MD, FAAFP

Everyday Health: What’s the Connection Between Headaches and Dizziness? By Becky Upham. Medically reviewed by Jason Paul Chua, MD, PhD

Healthline: Pressure in the Head: Causes, Symptoms, and Treatments; by Carly Vandergreindt, Medically reviewed by Seunggu Han, MD

Calm Clinic: How to Stop Anxiety Dizziness; by Micah Abraham, B Sc, Fact Checked by Vivian Okirie, MD

Pacific Neuroscience Institute: Balance Disturbance

Mayo Clinic: Benign paroxysmal positional vertigo (BPPV) and Dizziness

The Vestibular Disorders Association (VeDA): Coping and Support and Symptoms Diary

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Dr. Hintze completed his Pharm.D. at Idaho State University College of Pharmacy in Pocatello, Idaho in 2019. He pursued a PGY1 Pharmacy Practice Residency at the University of Oklahoma College of Pharmacy in Oklahoma City, Oklahoma and a PGY2 in Critical Care Pharmacy at University Hospital in San Antonio, Texas. Dr. Hintze’s teaching and research interests include medication therapy following traumatic brain injury, neurocritical care, pharmacotherapy for critically-ill patients, and pharmacy student/ resident development. He is currently a Clinical Assistant Professor at Texas A&M Rangel College of Pharmacy with a clinical practice site in the emergency department at St. Joseph Health in Bryan, TX.