Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Severe Headache, Lightheadedness And Pupil Enlargement In One Eye?
Question: I'm a little concerned, I recently began having a lot of headaches and lightheaded feelings. I also recently noticed one pupil is larger than the other. aside from anemia I am healthy. I'm not sure what it can be. I've had a eye exam and ct angiogram of my head, both which were normal, not sure if I should still be concerned or what this can be from.
Brief Answer:
No reason for concern.
Detailed Answer:
I read your question carefully and I understand your concern.
I see that you have been worried about having a dissection due to the pupil asymmetry. I would have added to that the possibility of an aneurysm of one of the arteries in the brain, the posterior communicating artery which can lead to dilation of the pupil on one side.
However luckily for me you make my work easy as you have had an angio CT of the head which is a highly sensitive exam for aneurysms so no need to worry about that. It also has a high sensitivity for dissection as I assume it has included the neck vessels. Also dissections usually are related to a trauma, or certain movement/postures of the neck in people who have a predisposition due to a connective tissue condition, so likelihood of a dissection was low even before the CT.
So as a conclusion I do not think you should be concerned given your normal CT. Pupil asymmetry can be found normally in many people. As for headache and lightheadedness they can be a feature of the anemia which you mention to have. They can also be a harmless primary headache like tension type headache, the most common primary headache (primary meaning without a detectable cause), which can be triggered/exacerbated by stress and anxiety. Relaxation exercises and activities like yoga can help with it apart from the occasional over the counter pain killer like Ibuprofen.
I remain at your disposal for other questions.
No reason for concern.
Detailed Answer:
I read your question carefully and I understand your concern.
I see that you have been worried about having a dissection due to the pupil asymmetry. I would have added to that the possibility of an aneurysm of one of the arteries in the brain, the posterior communicating artery which can lead to dilation of the pupil on one side.
However luckily for me you make my work easy as you have had an angio CT of the head which is a highly sensitive exam for aneurysms so no need to worry about that. It also has a high sensitivity for dissection as I assume it has included the neck vessels. Also dissections usually are related to a trauma, or certain movement/postures of the neck in people who have a predisposition due to a connective tissue condition, so likelihood of a dissection was low even before the CT.
So as a conclusion I do not think you should be concerned given your normal CT. Pupil asymmetry can be found normally in many people. As for headache and lightheadedness they can be a feature of the anemia which you mention to have. They can also be a harmless primary headache like tension type headache, the most common primary headache (primary meaning without a detectable cause), which can be triggered/exacerbated by stress and anxiety. Relaxation exercises and activities like yoga can help with it apart from the occasional over the counter pain killer like Ibuprofen.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
you were very through. thank you so very much.
Brief Answer:
You're welcome.
Detailed Answer:
Hope you'll feel better soon.
You're welcome.
Detailed Answer:
Hope you'll feel better soon.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
