Last month, we discussed some startling new research that found that lightheadedness upon standing up (orthostatic hypotension) may be more serious than previously thought. This month, we’ll look specifically at headache AND dizziness and if we should be concerned about this combination of complaints and if so, when?
A team of researchers from Johns Hopkins University reviewed past medical records of 187,188 patients presenting to over 1,000 emergency departments (EDs) between 2008 and 2009. They found the combination of headache and dizziness—especially in women, minorities, and young patients—was a potential signal of an impending stroke!
Specifically, they reported that 12.7% of people complaining of headache and dizziness were later admitted for stroke and had been misdiagnosed and inappropriately sent home from the ED within the previous 30 days. Patients were told they had a “benign condition” such as inner ear infection or migraine, and in some cases, they weren’t given a diagnosis at all. Slightly less than half of this population had a stroke within seven days and over half had a stroke within the first 48 hours of the initial pre-stroke ED presentation!
The study reported that women were 33% and minorities 20-30% more likely to be misdiagnosed, suggesting gender and racial disparities may play a role. The researchers estimate that doctors miss 15,000 to 165,000 strokes that result in harm to the patient each year.
Studies have found that the early diagnosis and quick treatment of strokes is critical in reducing serious residuals in patients having a transient ischemic attack (TIA), sometimes referred to as a “mini-stroke” or “pre-stroke.” TIAs are often pre-cursors to a more catastrophic stroke leading to death or permanent disability without appropriate treatment.
Again, to put this in perspective, MANY people present to healthcare providers with headaches and dizziness with NO relationship to stroke—about 87%—though it is sometimes not possible to know whether a potentially dangerous problem may arise in the near future. The good news is that it usually does not!
The importance of this study is to alert both healthcare providers AND patients of the potential risk. When in doubt, it’s ALWAYS best to seek out multiple opinions. An MRI may be the best way to confirm the most common type of stroke (according to the study reviewed above), as a CT scan may not show the brain changes early on and could lead to false reassurance.
Doctors of chiropractic commonly see patients presenting with headaches and dizziness. When this occurs suddenly, out of the ordinary, and/or at a relatively young age (women > men), it’s better to be safe than sorry and obtain multiple opinions, especially WHEN IN DOUBT!
You may wonder, “Do I need an MRI scan of my brain or neck.” Also, if you feel arm pain it may indicate things are getting worse and may indicate a bulge on the disc or worse yet a herniated disc in your neck. Some people have a feeling of their “head aching.”
What type of headache is it to include tension headaches, cluster headaches, migraine headaches, sinus headaches, or toxic headaches?
Regardless of the type, it can leave you feeling exhausted fatigued, nauseous, and even depressed. Some get severe pain behind the eyes. Persistent or worsening pain intensity and/or frequency necessitates a visit to see a professional.
Call me, Dr. Tim Harcourt, at (239) 278-3344 and mention this article for an awesome discounted first visit to include history, exam, and adjustment or Class IV high-intensity laser treatment.
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