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Feeling dizzy, vision blurred, headache and ringing ear. Will it cause ruptured aneurysm in brain?

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Hi, I have recently had some pretty disturbing experiences in my head over the last few days. It all began when I was lying in bed and suddenly my right ear began to pulsate quite loudly. This was followed by me feeling very dizzy and I started to lose my peripheral vision/blacking out. This went away but I have been experiencing headaches (behind the right eye and back of neck) that rise and fall sharply and a lot of congestion (sinus and right ear particularly blocked up). My headaches (pain behind and above right eye) build and fall quite suddenly. The right side of my face has been numb and my eye has been watering since. That was on Wednesday. Last night I was sitting in bed and the same thing happened (without the pulsating in the ear) and I stumbled and actually blacked out for a minute and was on my hands and knees. It didn't last very long, but has shaken me up. I've had much milder episodes of this today and am still very congested and my eye pain hasn't gone away with painkillers. My pulse is quite strong in my temples and all over my head. I am concerned that this could be related to a sentinel leak of an aneurysm because the symptoms just aren't going away. I am also experiencing a ringing in my right ear which has persisted throughout.

I think I should note that I have masturbated a few times without it increasing the pain. Is there a possibility that I am experiencing symptoms that may indicate an oncoming ruptured aneurysm in my head? I thought that as I had masturbated and increased my blood pressure in my head (I'm quite sure that this happens) that it would have already burst any sentinel leaking aneurysm. I am very concerned as my face on the right side is increasingly numb.

I'm 23, good BMI, don't smoke or drink.
Posted Mon, 23 Jul 2012 in Brain and Spine
Answered by Dr. Anil Grover 6 hours later

Thank you for writing in.
I am a medical specialist with an additional degree in the sub specialty of cardiology,
I read your mail with diligence. I must compliment you for eloquent description of your problem.

Four possibilities come to mind:
1. Stroke recurrent Transient Ischemic Attacks in right Anterior Cerebral Artery
region or left carotid region
2. Migraine,

3. Psedo Stroke caused by intra-cranial lesion in pituitary region (even infections,
highly treatable like hydatid cyst have caused such symptoms in famous people
such problems)

4. Some form of Temporal lobe seizures.

Points against first possibility are far too many. Twenty three is too young a age unless you have other cardiac anomalies or hypertension about which you have not mentioned. And minute differences in your perception of the episodes you have described.

Migraine can have varied presentation and what you have described is a typical XXXXXXX and subsequent episode occurs in many. Even hemiplegic migraine simulating stroke has been described.

Whenever, there is headache associated with peripheral loss of vision pituitary lesions (it DOES not mean malignant tumors only) should be considered.

If physical examination and investigations(including MRI if your doctor also deems fit) are not suggestive of others then a diagnosis of exclusion is Temporal lobe epilepsy.

My suggestion will be to fix an appointment with your doctor who may in turn take a neurology consultation or may order some investigations like Computerized Tomography or Magnetic Resonance Imaging before that. You please get back to me and we can plan further course of action fortunately, all conditions I am suspecting are eminently treatable.

Coming to your last two points no this is not the presentation of leaking aneurysm. Usual association is co arctation of Aorta which would have been picked up by now. And lastly, your pointing out about masturbation is quite normal in young men and is totally unrelated I would say no issue at all. You are otherwise fit I am happy to know about that.

Hoping this answer is of some help, I am looking forward to hear from you. You can walk to or get yourself taken to ER in case of further episode that would be quickest way to get expert's consult and investigations.

With Best Wishes

Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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