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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for dizziness, nausea and pressure headaches

Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3650 Questions

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Posted on Wed, 15 Mar 2017 in Brain and Spine
Question: I am 51 yrs old female weigh 160 lbs. good health. I have been experiencing dizziness for 21 days, accompanied by occasional pressure headaches. The only medication I take is for thyroid, my blood pressure is normal. In Dec. i fell while ice skating hit back of head had large bump iced it and it went down tender for about 1 week. In XXXXXXX while rappelling down waterfall about 100 ft. down on rope while swinging to move to side, my foot slipped and i hit the back of my head (area that was below my helmet) incredibly hard, I probably would have passed out but the cold water rushing and my fear of drowning kept me awake. I was very dizzy but managed to get down rest of the way. I iced it and it was very sore for about 2 weeks. It was 10 days later i began experiencing dizziness. I made a dr. appt. we tried meclizine for dizziness after 1 week it didn't help my dr. ordered a mri because 38 yrs ago i had an intracranial aneurysm from a mv accident and had fainting episodes. this was cleared up with medication. My dr. referred me to a neurologist which i have scheduled for 28th of Feb. because the MRI report suggests correlation clinically. The MRI impression: Nonspecific white matter signal changes without enhancement, edema or diffusion. Differential diagnosis includes demyelination, gliosis, or vasculitis. I am a little concerned as i haven't had any relief from the dizziness, I feel nauseous and have headaches some days. Am I correct in waiting to see the Neurologist or should i go to the hospital and bring the report and cd from MRI with me?
doctor
Answered by Dr. Olsi Taka 32 minutes later
Brief Answer:
Can wait.

Detailed Answer:
I read your question carefully and I understand your concern.

If I were to judge based on your account I would say that the symptoms are not related to the MRI findings. I believe they are more likely related to the hits you have taken on the head with possible whiplash and post concussion syndrome which may commonly manifest with headache and dizziness, may persist for a few months and needs mainly physical and psychological rest.

Regarding the diagnoses suggested by the MRI, the first two can certainly wait for the appointment. Demyelination means a condition like multiple sclerosis (MS). It is hard to exclude it without viewing images but the use of the term non-specific makes me think they are not in a typical distribution for MS. Also there are no active recent lesion, not responsible for these symptoms, so certainly can wait for appointment anyway.
Gliosis means simply remains from old injuries, sort of like small scars in the brain. Are commonly found, represent remnants from old issues, not an active process, may be due to that old accident you mention.
The last alternative given is vasculitis. It would be a little more worrying and require attention. Can manifest in an insidious way with few symptoms so difficult to exclude it with certainty. However the lack of enhancement, diffusion changes doesn't indicate an active rapidly evolving process, so I would say it can wait till the appointment in a week time.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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