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.
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.
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.
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.
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).
- Premenstrual tension (PMT).
- 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.
- Psychotropic drugs.
- 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.