pressure on head and dizzy

[licht70]

I am a 40 year old woman and I have been feeling pressure on my head and sinus, feeling dizzy  and almost fainted, called the ambulance and told me it was a panic attack because i had one before, but this time i feel is different because im still feeling like that after two days, and now im feeling pain on my neck too, and i feel strange, i was really scared to think it may be a tumor on my head or sthg like that, but i read on internet that a lot of people have the same symptoms that i have and have had a lot of tests done and can't find anything, i have also been having redness on my right eye not now but some days ago, and some weeks ago in both eyes, i thought it was pink eye or allergies, but now i think it may be related since some people complain of it too. I wonder if it may be related to the iron level in my blood, can it be too low? can that be the cause? because i was going to donate blood and they told me my iron level was not high enough to donate. Can someone help me please? I know i have to go to the doctor but now im on vacation in florida i will be back home in 2 weeks to make the appointment.

Thanks.

[Christopher R Newey, DO]

Again, thank you for using the forum. Again, this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor. It is difficult to comment on a formal diagnosis or treatment plan for your symptoms without actually examining you and obtaining a complete history. However, I want to provide you with some additional information regarding your symptoms.

Just some additional thoughts about headaches in the temporal region is that if you are older than the age of 55, one potential cause of headache/facial pain is called giant cell arteritis or temporal arteritis. This is due to an inflammation in the temporal artery and other arteries in the body. Symptoms include one sided headache pain in the temple and jaw that may be triggered by chewing. This condition can be diagnosed by a blood test called an ESR and a biopsy of the artery. It is very important to rule this diagnosis out as it is highly treatable and if left untreated it can lead to vision loss. It is exceedingly rare in people younger than 55, and is more common in even older age groups. I see that you are 40 years old, but I feel this condition should be remembered.

Another potential cause of temple pain is inflammation or arthritis of the temporo-mandiublar joint, commonly called the TMJ. This can sometimes occur due to bruxism, biting down at night or during the day, and other stresses to the joint. This is best diagnosed/managed by an orthodontist or an ENT, and treatment includes braces and other dental fixtures and sometimes muscle relaxants, depending on the exact cause.

A concerning cause of neck pain associated with headache is a dissection: a small tear in the blood vessels that travel up the neck to the brain. This can occur spontaneously in people with certain conditions that affect the blood vessels, after neck trauma, or after chiropractic manipulation of the neck. The pain is often but not always associated with some sort of neurologic deficit as a dissection can often lead to a stroke. This is why I mentioned that vessel imaging may be warranted based on the examination and clinical history your PCP/neurologist will obtain.

Thank you for using the forum, I hope you find this information useful, good luck.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to obtain a history from you and examine you, I can not comment on a formal diagnosis or treatment plan for your symptoms. However, I will try to provide you with some information regarding this matter.

Dizziness can have many causes and descriptions. Vertigo, or sensation of the room spinning, can be caused by several different types of inner ear problems and less commonly from central nervous system diseases. Cervical disease (such as a herniated disc in the cervical (neck) region or arthritis of the spine) can cause vertigo, though this is not common.  More often, the dizziness is not room-spinning per se but rather a wooziness or sort of light-headed dizziness. This is known as cervicogenic dizziness to some of the medical community. This notion of cervicogenic dizziness is not accepted by all medical practioners, it is controversial, as it is not well researched, difficult to diagnose, and difficult to conduct research on. However, it may be diagnosed in someone with neck pathology and dizziness in which no other cause is found. Therefore, it is a diagnosis of exclusion, after inner-ear and brain problems are excluded. These include Menniere's disease (which is marked by episodes of vertigo, ear-ringing (tinnitus) and hearing loss), benign positional paroxysmal vertigo (BPPV) which is marked by episodes of vertigo brought on by head movement, brain tumors (this would be apparent on MRI), certain toxic drugs (specific medications), neuropathy, and certain infections.

Patients with dizziness due to neck pathology (cervicogenic dizziness) often complain of dizziness that is worse with particular head movements and when the head is maintained in one specific posture for prolonged periods. Neck pain and a headache in the occipital region (the back of the head above the neck) may be associated with the dizziness. The dizziness may last minutes to hours after assuming certain head positions.

There is a condition called basilar migraine that is associated with several hours of vertigo and nausea, light-sensitivity, and sometimes other symptoms. Headache may or may not be present. The treatment is different from that used to treat other migraine types; the treatment in this case is a type of medication called calcium channel blocker, such as verapamil, which is actually used to treat blood pressure but works in type of basilar migraine as well.

As you mentioned, vertigo can also have a psychogenic origin. This type of vertigo is associated with anxiety and panic spells. This is a diagnosis of exclusion, but usually diagnosed in people with pre-existing diagnoses of anxiety or panic attacks.

Anemia, or low iron stores, can be associated with lightheadedness that may be perceived as dizziness. Also, if you have pain in your neck associated with the dizziness, you may need cervical imaging which should include the vessels since blockage or stenosis of the vessels supplying the brain can cause lightheadedness.

It is recommended that you follow up with your PCP to examine your symptoms and also obtain blood work. You may need to be referred to your local neurologist.

Thank you for using the forum, I hope you find this information useful, good luck.