Patient's Query
Hi doctor,
When lying on my stomach and propping my head up with my elbows, I experience intense head pressure. I feel like my head will explode and I will pass out. I also get a whooshing sound in my ears and tunnel vision. This occasionally happens when standing up from a seated position.
Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
I would like to know some details about your symptoms:
1. Since when have you started to have these headaches?
2. What type of headache do you feel? For example, stretching, heaviness, bursting, burning, pinprick, or something else?
3. What is the intensity of the headache: severe, moderate, or mild?
4. In one episode, how long does the headache last?
5. Is it associated with nausea or vomiting?
6. Does it get relieved soon if you lie down at that time?
7. Do you have a fever?
8. Is there any rhinorrhea, ear discharge, or hearing abnormality?
9. Does the whooshing sound in the ears and tunnel vision only occur at the time of the headache, or do they happen at other times than during the headache?
10. Have you ever undergone computed tomography (CT) or magnetic resonance imaging (MRI) brain scans for these symptoms?
11. Are you on any medications already? If yes, please give details.
Please undergo an MRI of the brain with contrast, including bilateral inner ear sections and cerebrospinal fluid (CSF) flow study, and a whole spine MRI.
Review the above-mentioned information for better understanding and further judgment.
I hope it helps.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
Here are my answers to your questions.
1. Since when have you started to have these headaches?
2. What type of headache do you feel? For example, stretching, heaviness, bursting, burning, pinprick, or something else?
3. What is the intensity of the headache: severe, moderate, or mild?
4. In one episode, how long does the headache last?
5. Is it associated with nausea or vomiting?
6. Does it get relieved soon if you lie down at that time?
7. Do you have a fever?
8. Is there any rhinorrhea, ear discharge, or hearing abnormality?
9. Does the whooshing sound in the ears and tunnel vision only occur at the time of the headache, or do they happen at other times than during the headache?
10. Have you ever undergone computed tomography (CT) or magnetic resonance imaging (MRI) brain scans for these symptoms?
11. Are you on any medications already? If yes, please give details.
Answers -
1. My whole life.
2. Bursting headache.
3. Severe pain.
4. A headache lasts until I can lie down on my back.
5. No.
6. Relief after a few minutes of lying down on my back.
7. No.
8. No.
9. It only happens when I get a headache.
10. No.
11. Effexor XR, but only for a year.
Thank you.
Hello,
Welcome back to icliniq.com.
As per your description, it seems to be a strong possibility of intracranial hypotension. I would like to know for which problem you are taking the tablet Effexor XR (Venlafaxine). Better assessment can be done if you answer the following questions:
1. Are you taking it for this headache itself? Or for something else?
2. What do you mean by whole life?
3. Since what age have you noticed this headache pattern?
4. Did you have any head injuries before the start of these symptoms?
Please undergo
If the diagnosis remains in doubt, I suggest a plan for lumbar puncture and measurement of CSF opening pressure with CSF biochemistry.
You must drink plenty of fluids, and you can have coffee.
I hope it helps.
Thank you.
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