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What Causes Persistent Pressure Sensation In The Head?

Posted on Thu, 16 Feb 2017

Question: Hello Doctor,

My symptom is pretty simple, but veeeeery distracting and sometimes renders me unable to think straight...

About a year and a half ago, I woke one day with this incredible lightheadedness; I don't mean vertigo, because the room doesn't spin. I mean it's like a cloudiness or painless pressure in my head that takes away my ability to think straight. It almost feels like there's a fog in my head. This comes and goes by months at a time (about 7-8 months ago was when I had this), now it's coming back.

Ive gone to an ENT, they found nothing. Went to the ER and had an MRI (to look for tumors), found nothing. I'm wondering what could cause this because an ENT couldn't figure it out, nor could an internal test (the MRI)?

It's frustrating and mildly frightening because I don't want it to keep taking my focus away and prevent me from doing the basics during my day.

Answered by Dr. Seikhoo Bishnoi (1 hour later)

Brief Answer:
Detailed work up is needed to make diagnosis

Detailed Answer:
Hello thanks for asking from HCM for your health related doubts

I can understand your concern. ENT work up found nothing and MRI scan too came normal so grossly we can rule out any organic cause. Lightheadedness, pressure in head, difficulty in concentrating could occur due to some medical reasons.

I hope you got your blood pressure, thyroid function tests, blood sugar levels checked and are normal. Hypertension could cause similar symptoms. Also get your eyes checked for refraction and IOP.

Nutritional deficiencies could also cause and deficiency of Vitamin B12 could be the possible reason. I'd advise you to get B12 levels checked to rule out this.

If that comes normal then anxiety could be the cause. Anxiety doesn't mean that you have some stress. Anxiety can occur due to ongoing day to day events and can present with symptoms like heaviness in head, light headedness, poor concentration etc. Low dose beta blockers can help to improve the symptoms. Propranolol can be used to relieve the symptoms. The drug can be used for some days and then can be stopped once you see improvement. Visit a doctor for evaluation of these symptoms and if needed visit to a psychiatrist.

Thanks. Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (4 hours later)

Understood. My blood pressure was/is normal.
I dont believe they did a thyroid exam and i do not recall my blood sugar levels (last time this happened, they were normal though).
I will get the other tests done for sure.
I hope its nothing scary and is easily fixed .

Answered by Dr. Seikhoo Bishnoi (7 hours later)

Brief Answer:
Yes get the tests done

Detailed Answer:
Hello again

Yes get the tests done and this will help in making a diagnosis. This is not a serious thing because MRI is normal.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (6 minutes later)

Now that i think of it, i believe it was a CT scan.
But it was still normal (about 8 months ago) .

Answered by Dr. Seikhoo Bishnoi (12 minutes later)

Brief Answer:
If CT was normal then no need to worry.

Detailed Answer:
Hello again

Even CT scan is a good investigation with good sensitivity. If that was negative and symptoms don't worsened after that then no need to worry.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Seikhoo Bishnoi (22 hours later)

Sounds good doctor. If i may ask one more...leaving work tonight, my left cheek became pretty hot/warm out of nowhere (not numb, i could feel the pain of me pinching the skin). Im wonderinf of these could be related maybe, and if not, what could cause this?

Answered by Dr. Seikhoo Bishnoi (13 minutes later)

Brief Answer:
This is related to anxiety only

Detailed Answer:
Hello again

Yes if we make provisional diagnosis of anxiety for your symptoms then this is related. Try to ignore such symptoms. These carry no significance because your investigations are normal.

Thanks

Above answer was peer-reviewed by : Dr. Kampana