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What Causes Persistent Headache, Positional Vertigo And Elevated Blood Pressure Levels?
Brief Answer:
Reactive hypertension
Detailed Answer:
Good evening. Sorry you are having troubles. You've given some good information but I'm a headache specialist who sees a lot of BPPV so of course, I'd typically like to get a lot of details on each of the conditions you mention.
First of all, the blood pressure may be elevated simply you've been suffering more uncomfortable and painful symptoms over the past 2 weeks for unknown reasons. This would be termed a reactive hypertensive reading. Of course, blood pressures typically vary diurnally so that at any given moment it could be high...that doesn't mean it stay that high at all times. If, however, you take it on several different occasions at different times of the day and also are in the most relaxed possible then, you may see whether these higher pressures are truly real or not.
If you've been having positional vertigo for the past 2 weeks which itself could CAUSE headaches to initiate if they are relatively continuous then, the quickest way to a solution for BOTH problems at once is to implement the BRANDT-DAROFF EXERCISES immediately and do them at least 2-3x/daily.
If your CT of the head is normal then, you know you're not leaking blood from an aneurysm suffering from some type of stroke, and don't have a tumor in the brain. Therefore, either the BPPV is causing the increased headaches and elevated BP (and by the way, WHAT TYPE of headaches are we talking about??) or it's a red herring and the headache and BPPV just came on by their lonesome and they are going to subside in due course.
My strong recommendation is that you address the BPPV (actively; please don't reach for meclizine....treat the underlying cause with the Brandt-Daroff maneuvers). My hunch is when that is addressed, everything else will fall into place I believe....at least it's worth a shot.
I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them in the context of your question.
Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.
Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.
Cheers!
This consult request has taken a total of 12 minutes of time to read, research, and respond.
Reactive hypertension
Detailed Answer:
Good evening. Sorry you are having troubles. You've given some good information but I'm a headache specialist who sees a lot of BPPV so of course, I'd typically like to get a lot of details on each of the conditions you mention.
First of all, the blood pressure may be elevated simply you've been suffering more uncomfortable and painful symptoms over the past 2 weeks for unknown reasons. This would be termed a reactive hypertensive reading. Of course, blood pressures typically vary diurnally so that at any given moment it could be high...that doesn't mean it stay that high at all times. If, however, you take it on several different occasions at different times of the day and also are in the most relaxed possible then, you may see whether these higher pressures are truly real or not.
If you've been having positional vertigo for the past 2 weeks which itself could CAUSE headaches to initiate if they are relatively continuous then, the quickest way to a solution for BOTH problems at once is to implement the BRANDT-DAROFF EXERCISES immediately and do them at least 2-3x/daily.
If your CT of the head is normal then, you know you're not leaking blood from an aneurysm suffering from some type of stroke, and don't have a tumor in the brain. Therefore, either the BPPV is causing the increased headaches and elevated BP (and by the way, WHAT TYPE of headaches are we talking about??) or it's a red herring and the headache and BPPV just came on by their lonesome and they are going to subside in due course.
My strong recommendation is that you address the BPPV (actively; please don't reach for meclizine....treat the underlying cause with the Brandt-Daroff maneuvers). My hunch is when that is addressed, everything else will fall into place I believe....at least it's worth a shot.
I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them in the context of your question.
Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.
Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.
Cheers!
This consult request has taken a total of 12 minutes of time to read, research, and respond.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. for your response. I will try the Brandt Daroff exercises today. You asked about the headaches. On the 1-10 pain scale, they run from a 2 or 3 to a 6 or 7. They seem to be primarily toward the top-front of my head -above forehead (both sides) as well as in the back on the left lower side. It is reassuring to know that treating one may relieve the other. As I am a bit of a worrier, it makes sense that my blood pressure is responding to the pain and my concern about the pain. My BP this morning was lower upon waking at 134/84. Does this mean that perhaps I don't have high blood pressure but perhaps as you suggest it's 'reactive'?
Is there anything I should watch for that would require another visit to the doctor's office? Again, Thank you, Dr. Saghafi.
Is there anything I should watch for that would require another visit to the doctor's office? Again, Thank you, Dr. Saghafi.
Brief Answer:
Nice to hear that the blood pressure has returned to a better baseline
Detailed Answer:
Good morning and thank you for the updates. Blood pressure readings are extremely volatile on a minute by minute by basis and perhaps are one of the body's yardstick measures that are least understood at times by patients (and even physicians) as well as misinterpreted. Variations are the rule as the day progresses and not the exception. These variations can go from very high numbers to very low numbers and every combination in between. That is why the diagnosis of blood pressure should never be made by anyone except after several readings under different circumstances (upon awakening, before meals, after meals, after exercise, before/after showers, etc. etc) have been made.
Therefore, I believe that your blood pressure has been adequately addressed and you should not either diagnose yourself or allow anyone else to diagnose you with a condition of blood pressure requiring medication because that would be tragic to be placed on something you don't need and to be labeled with something you don't have.
Secondly, yes- the Brandt-Daroff Exercises (BDE) are the standard types of maneuvers that are time tested and well grounded in scientific explanation as to how they operate, which are used the world over to treat and MAINTAIN anybody who suffers BPPV. There are countless educational sheets that can be printed from the Internet and even YOUTUBE videos by numerous individuals as to exactly how they should be performed. In some individuals the effect is almost immediate while in others it may take several days or several weeks (depending on how they do the exercises and whether or not they have someone helping them) to take effect. They sometimes need to be repeated several weeks or several months down the road so don't get too impatient or frustrated if you find that to be the case...the whole pathophysiology of BPPV explains WHY that should be the case. And I have had countless numbers of patients with headaches of a variety of types from migraines to tension type to clusters to Trigeminal Dysautonomic Cephalgias get relief from their headaches just by addressing something like BPPV. I almost never use medications in patients for this condition. Therefore, again, trying a nonpharmaceutical approach in my opinion is always superior in this type of setting since the treatment directly addresses the cause and avoids putting unnecessary medications into your body.
Also, for just a bit more quick education on headache medicine. The analogue scale everyone uses (perhaps even unknowingly to some extent) regarding the reflection of intensity ratings for headaches and their symptoms actually ranges from 0-10. It is called by different names such as the LEIKERT SCALE (with smiley faces) and there are others. But, the designation of the "10"/"10" headache should be thought of as an intensity level so strong and so intense that it literally drives a patient to seek EMERGENCY MEDICAL CARE...meaning to the hospital ER or URGENT CARE.....not almost there....not "nearly" drove me to the ER...but physically forced the patient to pick up 911 or call their neighbors and beg them to take them NOW.....that is a 10/10 pain. 0/10 is NO PAIN WHATSOEVER but symptoms can still be present..especially in migraine patients such as nausea, vomiting, blurred vision, etc.....so pain can literally be "0"....And then, the other numbers are in between. That is a more proper and specific designation of intensities using that scale but in your case I think it's somewhat academic since I believe a portion of your headaches may very well be contributed to by the BPPV situation. If after taking care of that you still have unremitting headaches of the more moderate grade that you refer then, it is time to seek out a specialist in headaches who can (as I do) guide you in the filling out of a headache diary and then, the search for what is causing such chronic conditions and to then, put a name on them.
Just as with blood pressure....headaches of the type you describe really need to be monitored and characterized over time before a final diagnosis can be made as to what they are, what may be causing them, and the best intervention or approach to treating them may be....
I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them in the context of your question.
Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback.
In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my responses as the end of the month tallies are upon us and such an action on your part would very much help the numbers I've accumulated for the month from a statistical perspective.
Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.
Cheers!
This consult request has taken a total of 40 minutes of time to read, research, and respond.
Nice to hear that the blood pressure has returned to a better baseline
Detailed Answer:
Good morning and thank you for the updates. Blood pressure readings are extremely volatile on a minute by minute by basis and perhaps are one of the body's yardstick measures that are least understood at times by patients (and even physicians) as well as misinterpreted. Variations are the rule as the day progresses and not the exception. These variations can go from very high numbers to very low numbers and every combination in between. That is why the diagnosis of blood pressure should never be made by anyone except after several readings under different circumstances (upon awakening, before meals, after meals, after exercise, before/after showers, etc. etc) have been made.
Therefore, I believe that your blood pressure has been adequately addressed and you should not either diagnose yourself or allow anyone else to diagnose you with a condition of blood pressure requiring medication because that would be tragic to be placed on something you don't need and to be labeled with something you don't have.
Secondly, yes- the Brandt-Daroff Exercises (BDE) are the standard types of maneuvers that are time tested and well grounded in scientific explanation as to how they operate, which are used the world over to treat and MAINTAIN anybody who suffers BPPV. There are countless educational sheets that can be printed from the Internet and even YOUTUBE videos by numerous individuals as to exactly how they should be performed. In some individuals the effect is almost immediate while in others it may take several days or several weeks (depending on how they do the exercises and whether or not they have someone helping them) to take effect. They sometimes need to be repeated several weeks or several months down the road so don't get too impatient or frustrated if you find that to be the case...the whole pathophysiology of BPPV explains WHY that should be the case. And I have had countless numbers of patients with headaches of a variety of types from migraines to tension type to clusters to Trigeminal Dysautonomic Cephalgias get relief from their headaches just by addressing something like BPPV. I almost never use medications in patients for this condition. Therefore, again, trying a nonpharmaceutical approach in my opinion is always superior in this type of setting since the treatment directly addresses the cause and avoids putting unnecessary medications into your body.
Also, for just a bit more quick education on headache medicine. The analogue scale everyone uses (perhaps even unknowingly to some extent) regarding the reflection of intensity ratings for headaches and their symptoms actually ranges from 0-10. It is called by different names such as the LEIKERT SCALE (with smiley faces) and there are others. But, the designation of the "10"/"10" headache should be thought of as an intensity level so strong and so intense that it literally drives a patient to seek EMERGENCY MEDICAL CARE...meaning to the hospital ER or URGENT CARE.....not almost there....not "nearly" drove me to the ER...but physically forced the patient to pick up 911 or call their neighbors and beg them to take them NOW.....that is a 10/10 pain. 0/10 is NO PAIN WHATSOEVER but symptoms can still be present..especially in migraine patients such as nausea, vomiting, blurred vision, etc.....so pain can literally be "0"....And then, the other numbers are in between. That is a more proper and specific designation of intensities using that scale but in your case I think it's somewhat academic since I believe a portion of your headaches may very well be contributed to by the BPPV situation. If after taking care of that you still have unremitting headaches of the more moderate grade that you refer then, it is time to seek out a specialist in headaches who can (as I do) guide you in the filling out of a headache diary and then, the search for what is causing such chronic conditions and to then, put a name on them.
Just as with blood pressure....headaches of the type you describe really need to be monitored and characterized over time before a final diagnosis can be made as to what they are, what may be causing them, and the best intervention or approach to treating them may be....
I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them in the context of your question.
Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback.
In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my responses as the end of the month tallies are upon us and such an action on your part would very much help the numbers I've accumulated for the month from a statistical perspective.
Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.
Cheers!
This consult request has taken a total of 40 minutes of time to read, research, and respond.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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