Headaches and Dizziness (Light Headed, Vertigo) Causes

A headache may often be accompanied by other symptoms and dizziness is one of the more common complaints that is reported along with the head pain. It is important to identify if the dizziness is a symptom of the condition causing the headache or whether the dizziness is the result of a headache.

Pain triggers a number of physiological changes in the body, like a change in blood pressure, blood glucose levels and the secretion of endorphins, and this can result in dizziness on its own. In other cases, like in increased intracranial pressure, dizziness may be a result of the pressure on the brain and not due solely to the pain response.

Dizziness vs Vertigo

While the terms dizziness and vertigo are often used interchangeably, there is a distinct difference between these two conditions.

Dizziness is a vague term but may indicate any sensation from a light headed feeling, faintness (just before one faints), impaired balance, changes in steadiness to cognitive disturbances (which may be described as ‘brain fog’, ‘spaced out’ or ‘high’).

Vertigo is slightly more precise in indicating the perceived sensation. In this instance the sensation is that of the environment spinning around, usually with impaired balance and steadiness.

For the purpose of this article, the term dizziness will include vertigo.

It is also not uncommon for patients to experience other symptoms with dizziness, apart from the headache, like nausea and vomiting. Refer to the article on Headache, Nausea and Vomiting.

Causes of Headaches and Dizziness

The following are the more common causes of headaches with dizziness. These conditions should first be excluded before investigating further for other causes unless obvious symptoms point to a specific condition or cause.

Migraines

Dizziness may be a part of the aura preceding the migraine or a feature of the migraine attack itself. Sometimes the sensation is closer to that of vertigo. Refer to the articles on Types of Headache and Migraine Headache Triggers for more information on migraines.

Hypoglycemia (Low Blood Glucose Levels)

A decrease in blood glucose levels may trigger a headache and is often accompanied by dizziness. If there is a gradual drop in the blood sugar level, the patient may experience a light headed feeling initially which may progress to severe dizziness. In cases of a sudden drop in blood glucose levels, there may be the sudden onset of severe dizziness resulting in syncope (fainting).

Diabetics may experience a headache with dizziness when their blood glucose levels spike to dangerously high levels.

Blood Pressure Abnormalities

Both high blood pressure (hypertension) and low blood pressure (hypotension) can present with headaches and dizziness, as well as blurred vision and nausea. Dizziness triggered or aggravated by a sudden change of position, like suddenly standing up, may be indicative of postural hypotension. However, the link between changes in blood pressure, particularly hypertension and headaches is still somewhat controversial although many hypertensive patients report a headache when their blood pressure spikes.

Infections

The symptoms of an acute systemic infection, like the flu,  includes headaches with dizziness and features of a systemic infection may also be present like a high fever, chills, fatigue, lack of appetite and nausea or vomiting.

With more localized infections of the head like encephalitis, meningitis, a brain abscess and ear infections, headache and dizziness are common and outstanding features of the condition. Localized infections elsewhere on the body which are left untreated may progress into septicemia and headaches with dizziness is among the initial symptoms that appear with septicemia.

Trauma

Headaches and dizziness are a common feature of head trauma, especially where there is an increase in intracranial pressure either due to inflammation or hemorrhage. Other signs and symptoms may include mental confusion, excessive sleepiness and some sensory impairment. Usually there is a history of a head injury which precedes the onset of the symptoms.

Drugs

The side effects of many drugs include headaches and dizziness but this is common when using certain antibiotics, hypertensive and GERD drugs.

Other Causes of Headaches and Dizziness

  • Vertebral artery dissection.
  • Otitis media.
  • Stroke (cerebrovascular accident or CVA) or transient ischemic attack (TIA).
  • Hypoxemia.
  • Anemia.
  • Premenstrual tension (PMT).
  • Pregnancy.
  • Psychological disorders like anxiety, especially if there are panic attacks with hyperventilation.
  • Meniere’s disease.
  • Labyrinthitis. There may also be some hearing loss and/or tinnitus.
  • Ruptured ear drum (tympanic membrane). There may be some hearing loss, tinnitus and ear pain.
  • Acoustic neuroma.
  • Motion sickness.
  • Heart attack. This is a medical emergency and there will be other symptoms like chest pain (Heart Chest Pain), sweating, arm pain, fainting spells, nausea and vomiting.
  • T4 syndrome.
  • Injury to the cervical spine.
  • Brain stem injury.
  • Herniated disc. Refer to the article on Pinched Neck Nerve.
  • Spasm of the neck and/or back muscles.
  • Heat stroke.
  • Dehydration. Refer to the article on Headache in Dehydration.
  • Poisoning. Nausea and vomiting, along with stomach cramps may also be present.
  • Sinusitis.
  • Psychotropic drugs.
  • Narcotics.
  • Alcohol intoxication and hangover.

The conditions above are not the only causes of headaches with dizziness and medical attention is necessary to isolate the exact cause.

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  • moshorocky

    I am a 30-yr old female that has been dealing with dizziness for the last 7 months. It comes & goes throughout the day. I have been to a neurologist, and all they have done is sent me to physical therapy, which has not really solved the problem. I am now getting the dizziness with headaches shortly after. I recently had a MRI done, but the test came back completely clear. They are at a loss on what could be causing it. I do have carotid steno sis, but I take a low-dose aspirin every morning to take care of that. I am looking to see if anyone has any ideas on what could be causing this. It has become a problem & hindrance on my life. Thank you.

  • Dr. Chris

    Hi Moshorocky

    Dizziness can be due to many causes. The issue that comes into question here is whether the dizziness is due to a medical condition or just a perceived sensation like is the case with vertigo. The fact that the condition is not progressing further in these 7 month may be a good indication that it is benign (does not pose a major risk to your health), however, it is always good to be cautious and monitor whether this is progressing further or if other signs and symptoms may be present.

    The fact that you are seeking help from a medical specialist means that all the obvious causes like sudden changes in blood pressure, blood sugar levels and so on should have been excluded. Of course your carotid stenosis is worrisome. It is a major risk factor for a stroke and this is preceded by acute attacks of dizziness which is known as TIA (transient ischemic attack). This must have been excluded by your neurologist. You should also see an ENT and determine whether this dizziness is not due to an inner ear problem. Also take note when the dizziness comes and what preceded it – change in position, stress and so on. This is helpful for your doctor to isolate the cause.

  • orten

    hi, first i would like to thank you
    here’s what i got
    i dont count but its about 2 or 3 years i suffer from Headache and Dizziness
    just before one faints
    Simple continuous headache
    Dizziness general
    Balance
    Cognitive effort, with the turnover and very painful blows in the middle longitudinal movement when suddenly like standing suddenly
    Blurred vision
    \ Respiratory problems

    plz help me
    thanks alot doc

  • Dr. Chris

    Hi Orten

    Headaches and dizziness can be due to many causes. The question here is whether the headaches and dizziness are related or not. The fact that you balance, coordination, visions and cognitive functions (if I understand you correctly) are affected does indicate a possible neurological problem. If you have also noticed a fever, please speak to your doctor about testing for a number of generalized infections like HIV.

  • ladyred_1960

    I had 2 brain bleeds & 1 TIA since June. now my symtoms go like this:
    I fell light-headed, blood pressure dips, then dizzy, I faint, out 1-2 min, come to, move to bed, within 5 minutes sudden severe headache begins followed by, nausea, vomiting, mumbness on one side. have had test after test, nothing found. changed meds around, no change. added florinef 0.2mg 3 x a day & prednesone 10mg 1 a day to raise BP, small improvement, now seeing endocrinologist, adrenal insufficincy test was negative. Can any one help, desperate for something to explain.

  • Dr. Chris

    Ladyred_1960

    TIA does not just occur once off. Who diagnosed it as a TIA? Your “brain bleeds” were due to which artery rupturing? Was there a history of an aneurysm? The information here does not seem to add up when you state that nothing has been found in test after test. I think you need to sit down and discuss this with your physician as there may be some confusion here.

  • catshaff

    I too am having dizziness, which brings on the motion type sickness, nausea and then a type of headache, but not like a migraine. More of a pressure feeling above my ear and aacross the top of my head. Sometimes it is when I lay down , I feel as though I am on a merry go round. Sometimes just walking to the check out at the store, I get so dizzy and things go dark , but if i hold still , my sight returns to normal , but the nausea remains for awhile and then once the dizziness leaves, the headache starts and i feel pressure in my head and eyes. Please help me if you can, I am going to go for a cat scan in the morning.

  • Dr. Chris

    Hi Catshaff

    What has to be excluded here is any blockage of the coronary artery or conditions that may be predisposing you to a stroke. These episodes that you are experiencing could be a TIA (transient ischemic attack) which is caused by a sudden disruption of oxygen rich blood to the brain. Early treatment is crucial in order to prevent a stroke.

    This could also be a middle or inner ear problem. You should see an ENT specialist (Ear-nose-throat / otolaryngologist) to investigate for the possibility of an ear problem.

  • catshaff

    Thank you for answering me, I am waiting to get my results. Just thank you thank you!!

  • Tina

    I have vertigo type dizzy spells every other day. Feels like the room is moving round and round. Recently, I notice a pressure headache and nausea as well. What could this possibly be caused from?

  • LoLo55

    Hi,

    I have been experiencing dizziness for a while now and I can’t seem to get away from it. Since this past Tuesday, I developed a sudden headache and experiences severe dizziness that seems like it won’t dissipate. I went to the ER got a cat scan and a spinal tap and everything was read to be ok, but I’m still feeling like crap and they gave me no explanation for it. I’m a very active person and this is starting to interrupt my daily activities. I just want to know what’s going on. I’m not sure if this has anything to do with this, but I become severely dizzy and irritable if I don’t eat every couple of hours.I didn’t think this was related because the dizziness and headaches are continuous even if I eat. Any suggestions? Thanks.

  • Dr. Chris

    Hi Tina

    The various causes are listed above. If it started up suddenly, it could be due to an infection in the middle/inner ear. Pregnancy and blood pressure changes, as well as sinsusitis may be other causes. You need to see a doctor who can examine you and conduct other tests to verify the cause.

  • Dr. Chris

    Hi Lolo55

    The dizziness and headaches may be related to low blood sugar levels (hypoglycemia). Even after eating the pain and dizziness may not ease fully. This is just one consideration since you mentioned the relation to meals. There is no way of knowing for sure without further testing. A complete blood workup should be done. Considering that it came on so suddenly, an infection, especially meningitis or encephalitis was a reasonable consideration and therefore the spinal tap was done. Now that it has been excluded you have to consider other factors like high blood pressure, blood glucose disturbances and so on. These are common causes. Pregnancy and hormonal condition may also be a possible cause. If none of these yields any results, kidney function etc needs to be assessed. Speak to your doctor. Other symptoms will help isolate a possible cause. Remember that one of the common causes of these symptoms is stress and muscle spasm in the neck.

  • Liko

    My boyfriend has been in a lot of pain for the past few months, he says it feels like his head is caught in a vice – he has to actively try to keep from crying from the pain when he comes to bed.
    He’s also been having trouble balancing himself. He can manage to walk and drive well enough to get by, but running or riding a bike are completely out of the question. He thought it was his ear that wasn’t draining properly, but a trip to the ENT resulted in… nothing being wrong. The most that came up was that his ear was ‘a little red’
    He’s had two CT scans in the past month, both have come back clean.

    I’m not sure if this is relevant, but he also has a red mark on his forehead since the pain started, after pussy-footing around hematomas and infections, we have no idea what it is. It isn’t a hematoma, and it hasn’t responded to 3 different kinds of antibiotics.

    Any ideas?

  • Dr. Chris

    Hi Liko

    It would be a good idea to repeat the CT scan in another month or so to check if any pathology that may be progressing eventually becomes evident. A complete blood workup is also advisable, including a complete blood count (CBC) and possibly even an autoimmune screen. Some less common viral infections as well as autoimmune conditions, like SLE, could account for these symptoms (rash and headache). Of course, this is based on the assumption that more common causes like a middle/inner ear disorder and muscle spasm has been excluded. At this point it may be advisable for him to consult with a neurologist. It has to be clearly identified if there was any trauma preceding the onset of these symptoms – even if minor, this has to be reported o the doctor.