Dizziness & Headaches

In the general population, dizziness has several possible causes, including inner ear disturbance, motion sickness, and medication side effects. It can also be caused by an underlying health condition, such as poor circulation, infection or injury. In brain injury patients, however, dizziness can also be the result of disruption of the autonomic nervous system. The autonomic nervous system is the part of your nervous system that controls muscles of internal organs, such as the heart, blood vessels, lungs, stomach, intestines, etc., and also controls glands, such as salivary glands and sweat glands. Feeling dizzy after sustaining a brain injury is common, and depending on the severity of the brain injury, feeling dizzy can be mild and annoying or severe and debilitating.

Headaches, on the other hand, can be the result of chemical activity in your brain, the nerves or blood vessels surrounding your skull, the muscles of your head and neck, or some combination of these factors. In brain injury patients, headaches can also be caused by small collections of blood or fluid inside the skull, or after surgery as a result of spinal fluid leakage. Sustaining headaches after a brain injury is also common, and occurs in up to 90% of all cases, even after a mild brain injury.

We cover dizziness and headaches together, because dizziness may come on before or after the headache. Also, stress or anxiety, particularly if you tend to hyperventilate, may lead to feeling headaches and dizziness. Dizziness or vertigo with a headache may be a sign of vestibular migraine and can occur in any of the phases of a migraine, according to the American Migraine Foundation. The word “vestibular” is used to describe the inner ear and a person’s sense of balance. Vertigo, dizziness, headaches, and disequilibrium are common symptoms following a concussion or even a mild brain injury.

Our experience

Sarah has had headaches since her childhood, and her pediatrician chose not to do a brain scan. After her brain hemorrhage, we have discovered that her birth defect of arteriovenous malformation (AVM) was the root cause of her headaches then. Sarah also has had frequent complaints of headaches and dizziness after her hemorrhagic stroke, and later we understood that her blurred vision, loss in the field of vision, and her brain overcompensation was partly to blame. But Sarah’s brain injury was also to blame for her vertigo, dizziness, headaches, and disequilibrium. Sarah was prescribed treatment for her vertigo, and Effexor for her migraine, all of which helped with the headaches and some of the dizziness.

In my case, I had suffered from serious and prolonged headaches after my brain surgery, and the likely suspect was the spinal fluid leakage, plus my prior brain injury. Eventually, it resolved itself months later, and I remember how coffee was more helpful than any medications that I have tried. I have also suffered from dizziness and headaches after my accident, likely the result of my double vision condition, and the consequential overcompensation. I know this because dizziness and headaches slowly but surely disappeared after my double vision condition improved. I have also suffered extended episodes of dizzy spells after starting my neurology medication Tegretol, which I was prescribed for a neurological condition known as trigeminal neuralgia (TN). TN can happen on its own, or can be the result of prior brain injury. I was not on Tegretol for long, as my condition escalated rapidly until I had a brain surgery to correct it. Then I was taking Keppra to help with the remaining symptoms.


The first action in combating symptoms of dizziness, headaches, or both, is to make sure that your doctor and neurologist are aware of those symptoms and details. Then, make sure that all your testing has been completed, and the recommended treatment has been followed. This will help you eliminate any other cause for your symptoms, especially the spooky ones. Second, look at your medication list and side effects, as some medications, especially neurology meds, may cause additional symptoms as side effects. It is important to note two things about neuro meds. First, the need to slowly increase to the prescribed dosage, and also slowly decrease when reducing the dose, or stopping all together. Second, neuro meds may take some time for the body to adjust. Until then, you may feel dizzy as a result of adding new neuro meds, or increasing your dose, so give yourself time until you reach your equilibrium.

If you have been told that your autonomic nervous system has been impacted by your brain injury, here are some things that you can do, in addition to your medical treatment. First, wear a knee-high compression sock, this will help improve blood circulation to the brain, thus improving your dizziness. But you may ask, what do my legs have to do with my head? Good question. It turns out that gravity has become your foe, as the autonomic nervous disorder does not utilize the muscle in the legs effectively, in order to push the blood upstairs. So gravity keeps more blood in your legs when standing, and compression socks will do wonders. Try 15-20 or at least 20-30 strength compression. Also, stay super hydrated, try smart water, or use mineral additives in your water, like Nuun or Liquid IV, that will help a great deal. Whatever you do, stay away from alcohol, it is not good for your condition, does not work well with neuro medications, and will work against all these helpful steps.

When you feel dizzy, it is important to take your time and slow down when doing things like getting out of bed, getting off your comfortable couch, and bending or turning your head. If you feel dizzy, get up slowly, sit on the side of the bed or couch for a minute or two. Before standing, start rotating your feet around and bend and straighten your legs a few times. Then, stand for a minute until you get your bearings and before walking. If you feel dizzy while walking, then stop and lean on something sturdy, breathe for a few minutes, then try walking again slowly. Whatever you do, don’t drive or operate any equipment or kitchen appliances that may cause harm. This may sound simple, but dizzy symptoms may come anytime, in a split second, with unpredictable duration, and usually leads to difficulty with balance.

As for your headaches, it is important to note that we keep much of our stress in our neck and shoulders, so let’s do something about that first. Start by correcting your posture, and get a prescription for neck and shoulder physical therapy. Follow through your PT exercise, and add some exercises of your own, like swimming or walking. Not only will this help your neck and shoulders, but it will also help your whole body and mood as well. Also, stay well hydrated, dehydration always leads to headaches. Try using smart water, or use hydration additives- those minerals will help boost your hydration. Finally, try caffeine. While excessive caffeine can be dehydrating, you will be amazed what a cup of coffee or two will do for headaches. But you should use the trial and error technique to figure out what works best for you.

Peeling away all these layers of cause and effect will help eliminate additional and common culprits that are not related to your brain injury, but perhaps brought about with the stressful consequences of your brain injury. If you are still feeling dizziness and headaches after all these steps, then try slowing down, find ways to reduce your stress level, simplify your life, and take a break whenever possible- listen to music, etc. Providing all related conditions are treated, the dizziness and headaches will eventually go away, but faster with your help.