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Neurology (Expert Forum)
Head Pressure/Stroke Worry
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Head Pressure/Stroke Worry
by Kanga, May 31, 2001 12:00AM
I am a 38year old male, with recently diagnosed mild hypertension (typically 140/90). I am not particularly overweight (190lbs, 6'0"). I do not smoke, drink reasonably moderately (normally two days a week alcohol free, 2-3 standard drinks other days), and walk/run 3.75miles 3-4 days per week. My work is white-collar, office bound and prone to regular senior management stress levels. I have had the regular blood tests and cholesterol, lipids, kidney functions and white & red blood cell counts are in the normal range.
For the last 5 years I have had a feeling of extreme pressure in my head, at first sporadic but now pretty much constant. The symptoms are a sense of pressure around the temples, near the vein in the front (external) portion of the ear (near the temple), and a periodic tension/tightness in my cheeks & scalp. There is also a mild "ringing" sound in my ears – not what I'd call tinnitus, but more the sense of blood rushing through the veins.
In the last two weeks I have commmenced a week course of Avapro (75mg tablets) to try and reduce the blood pressure. Home monitoring has shown some reduction, though it is still occassionally at or near 140/90. I had hoped that this would reduce the sense of pressure in my head, though there does not appear to be any relief.
The pressure symptoms can be relieved temporarily by "unblocking my ears" (holding my nose, and blowing as you would during a plane descent). While I do not suffer from sinusitis, the symptoms appear similar to those associated with the condition. I went to an Ear Nose & Throat specialist, having had a CT scan of my sinus in the last few years. I have no sign of any sinus infection, but do have a very badly deviated septum. It deviates in both directions at various points in my nose, giving very bad air flow through my nose. In addition, the deviation is such that it is possible the soft tissue inside the nose is contacting the septum. Lastly, I have no sense of smell. I suspect it is from a shock to the head which occurred when I was a child, as I have no recollection of any odours. I do have a sense of taste, but I suspect it is probably not the most sensitive palate on the planet.
Seems to me the pressure I am feeling could be caused by:
a) vascular problems (the Irbesartan should help)
b) physical problems (a blockage in a major artery?)
c) organ problems (eg kidney problems causing hypertension)
d) other disease (cancer? MS?)
My questions are:
1) What could be causing the sense of pressure in my head? Is it possible the nose soft-tissue contact would be causing it? Is it likely surgical correction of the septum would alleviate these symptoms?
2) I am concerned that the pressure in my head could eventually lead to a stroke. While medication is bringing down blood pressure, the sense of pressure in my head has not dimished. Is it possible the blood pressure in my head is different to that measured on my arm, and if so how would it be measured? Is it possible the hypertension medication could weaken aterial or venous walls, increasing the risk of a stroke?
3) If the pressure is caused by a blockage, would an MRI reveal any the source of blockage? Would it indicate weakness of brain arteries or veins? Other diseases?
Any feedback would be appreciated,
Kanga.
For the last 5 years I have had a feeling of extreme pressure in my head, at first sporadic but now pretty much constant. The symptoms are a sense of pressure around the temples, near the vein in the front (external) portion of the ear (near the temple), and a periodic tension/tightness in my cheeks & scalp. There is also a mild "ringing" sound in my ears – not what I'd call tinnitus, but more the sense of blood rushing through the veins.
In the last two weeks I have commmenced a week course of Avapro (75mg tablets) to try and reduce the blood pressure. Home monitoring has shown some reduction, though it is still occassionally at or near 140/90. I had hoped that this would reduce the sense of pressure in my head, though there does not appear to be any relief.
The pressure symptoms can be relieved temporarily by "unblocking my ears" (holding my nose, and blowing as you would during a plane descent). While I do not suffer from sinusitis, the symptoms appear similar to those associated with the condition. I went to an Ear Nose & Throat specialist, having had a CT scan of my sinus in the last few years. I have no sign of any sinus infection, but do have a very badly deviated septum. It deviates in both directions at various points in my nose, giving very bad air flow through my nose. In addition, the deviation is such that it is possible the soft tissue inside the nose is contacting the septum. Lastly, I have no sense of smell. I suspect it is from a shock to the head which occurred when I was a child, as I have no recollection of any odours. I do have a sense of taste, but I suspect it is probably not the most sensitive palate on the planet.
Seems to me the pressure I am feeling could be caused by:
a) vascular problems (the Irbesartan should help)
b) physical problems (a blockage in a major artery?)
c) organ problems (eg kidney problems causing hypertension)
d) other disease (cancer? MS?)
My questions are:
1) What could be causing the sense of pressure in my head? Is it possible the nose soft-tissue contact would be causing it? Is it likely surgical correction of the septum would alleviate these symptoms?
2) I am concerned that the pressure in my head could eventually lead to a stroke. While medication is bringing down blood pressure, the sense of pressure in my head has not dimished. Is it possible the blood pressure in my head is different to that measured on my arm, and if so how would it be measured? Is it possible the hypertension medication could weaken aterial or venous walls, increasing the risk of a stroke?
3) If the pressure is caused by a blockage, would an MRI reveal any the source of blockage? Would it indicate weakness of brain arteries or veins? Other diseases?
Any feedback would be appreciated,
Kanga.
Doctor's Answer
by CCF-Neuro-M.D.-RPS, May 31, 2001 12:00AM
Dear Kanga:
I am sorry to hear of your hypertension and "head pressure". The sense of head pressure can be due to multiple things, for instance if you had a middle ear infection sinus infection (as you mentioned) or inner ear problem. In addition, some types of headache can give a feeling of pressure in the head. So, just from your description I can tell you what is causing your head pressure. Since you have had your deviated septum all your life, I would think of this at the bottom of the possibilities, but it is a consideration. The vessels in your brain are under fine controls for pressure regulation and would not be giving you a feeling of pressure in your head, although if your pressures were high enough for a long enough period of time, they could give you headaches. Yes, intracranial hypertension can induce vessel wall damage. If you had blockage of a brain vessel you would have a stroke, so likely not causing you just head pressure. There are a myraid of diseases that can give you headaches or head pressure, much too long to list here.
I would bet on a headache as inducing your symptoms.
Sincerely,
CCF Neuro MD
I am sorry to hear of your hypertension and "head pressure". The sense of head pressure can be due to multiple things, for instance if you had a middle ear infection sinus infection (as you mentioned) or inner ear problem. In addition, some types of headache can give a feeling of pressure in the head. So, just from your description I can tell you what is causing your head pressure. Since you have had your deviated septum all your life, I would think of this at the bottom of the possibilities, but it is a consideration. The vessels in your brain are under fine controls for pressure regulation and would not be giving you a feeling of pressure in your head, although if your pressures were high enough for a long enough period of time, they could give you headaches. Yes, intracranial hypertension can induce vessel wall damage. If you had blockage of a brain vessel you would have a stroke, so likely not causing you just head pressure. There are a myraid of diseases that can give you headaches or head pressure, much too long to list here.
I would bet on a headache as inducing your symptoms.
Sincerely,
CCF Neuro MD
And also, for the last 4 years I have had a feeling of tight pressure around my temples. It is usually worse when I am most active and then it calms down when I get home, drinking or not. I never have headaches. This is not painful. It's just very irritating.
I do not have a deviated septum, but I don't have the greatest airflow through my nose either. But I have only had this feeling for about the last 4 years.
Please let me know what this could be. It's comforting to see that I am not the only one with this feeling. Like I said, I have no pain. It's just a tight pressure around my temples. And it feels worse when I am over-active and/or stressed.
Is there anything that I can take over the counter to help lower the activity in the brain and/or reduce the tightness and pressure around my temples? Can being dehydrated from alchohol cause something like this? I just quit drinking coffee too, that seemed to help but the feeling is still there.
Thanks
At first my GP thought it was a viral infection simply could be cured with rest. I have been sent to a neurologist who thought it could be an anyuersm, however the MRI scan showed up clear. I also have a severe infection