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Weird pressure inside forehead with headache and nosebleeds, affected vision. Should I worry about brain aneurysm ?

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General & Family Physician
Practicing since : 2004
Answered : 1678 Questions
I have had this weird pressure inside my forehead all day today accompanied with a mild headache and a few mild nosebleeds. There were periods when even my sight was affected, as I could not see properly because of some gray spots that blocked part of my vision. On top of everything I get this very sharp pain in the right part of my forehead/head when I quickly shake my head from side to side. This sharp pain is much more intense if I shake my head while I am bending over and my forehead faces the ground. This last symptom (sharp pain in part of my head while shaking it from side to side) seems to occur every time after swimming (especially for longer periods under water)
Some one told me it could be related to the supply of oxygen to my brain or even Vertebrobasilar Artery Tortuosity or even worse brain aneurysm? Could you please tell me if it's something to be worried about? Should I see a doctor? Thank you
Posted Mon, 21 May 2012 in Headache and Migraines
Answered by Dr. Chakravarthy Mazumdar 4 hours later

I wish to have the following information as well before I give considerable opinion:

Is this the first time you happen to have this kind of feeling/ sharp fore head pain?
Are you allergic to pollen, dust etc? Do you frequently have runny nose accompanied by facial pain? Do you suffer from asthma related illnesses?
When do the headache typically start in a day and last for?

These are the following points to consider:

-30yr old male
-Pressure in the forehead all day
-Mild nose bleeds
-Sharp pain on the fore head which increases on bending forward and after swimming.

At this age we need to consider common causes like primary tension headache, migraine and sinus headache.

Tension headache usually accompanies with stiffness of neck, shoulder muscles. It pre factors few stresses in life. They accompany with nausea.

Migraine headache is generally one sided though can spread on both sides, aggravated by noise, light. One can predict the start of it and accompanied by nausea.

A forehead pain that increases on bending forward or after nasal congestion (swimming can increase the congestion in the nasal cavity and sinuses) accompanied by pain and redness on the face, any physician should first think of sinusitis. So if I am your physician I would probe history further, examine the nasal, throat cavities. An Xray of the nasal sinuses can be helpful.

I absolutely doubt if it is Vertebro basilar artery tortuosity or a brain aneurysm. They come into picture if all of the above reasons fail to draw a conclusion. In such a case, MRI scan of the brain is needed.

I would suggest a preliminary examination by your primary physician.

Please rate my answer if you do not have any follow up enquiries.

Above answer was peer-reviewed by
Follow-up: Weird pressure inside forehead with headache and nosebleeds, affected vision. Should I worry about brain aneurysm ? 6 hours later

please find the additional information you have requested:

I can only feel the sharp pain in the right side of my fore head when I quickly shake my head sideways. I have been having this for years, at least 5 (perhaps more) and it does not happen too often (maybe once or twice every two months). I have not been able to observe any kind of pattern as to when this kind of headache starts, it comes and goes randomly except for when I go swimming, it seems to occur regularly, every time after swimming. Sometimes it goes away after a day or two, other times I feel it if I shake my head for close to a week. This is the first time I have had the nose bleeds.
I XXXXXXX not have allergies of any kind and I don't suffer from asthma or similar illnesses.
I very rarely have runny nose and I don't recall having any kinds of facial pain. Although, it was a bit runny this morning, it's not blocked/congested though.
My fitness and health in general is very good. I live in Sydney, Australia and less then a week ago I returned from Phuket, Thailand, where I spent a week. That was a significant climate and temperature change. I am mentioning it just in case that could have played a role as well.
Otherwise I just wanted to find out what that sharp pain inside my fore head (only when I shake my head though), I have been having for years, is and why.
Thank you
Answered by Dr. Chakravarthy Mazumdar 4 hours later

Thank you for additional details.

Since the frequency of the pain is not too often it should not interfere in you daily life. Am I right?

There is no history of allergies, asthma and frequent runny nose. Hence the chances of it being sinus headache is rare.

The next possibility is a non specific headache is simple dehydration and fatigue. This is evident when you complain of a headache after swimming. Swimming drains a lot of energy. The cells bloats with fluid transfer from intercellular spaces to intracellular space. The most common reason (90%) of the headache arise out of dehydration or inadequate consumption of fluids and electrolytes.

The other reason which I could think of are equilibrium issues due to position of the head. The hair cells in the inner ear contribute to balancing of head when there are sudden positional changes such as shaking of head. If the response is slow from the cells the head experience such sharp pain. This is can be one sided as well. This requires no treatment.

You are right mild nasal bleeds can be caused by changes in the temperature.

I do not think there is any need to worry at this point in time.

Hope this answer throws some light on your problem and take necessary steps. Please rate my answer if you do not have any follow up queries.

Above answer was peer-reviewed by
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