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Your grandfather passes away and your grandmother begins complaining of chest pain. Is there a connection? Some people, especially women age 50 and older, may sustain heart injury after an intense physical or emotional event, such as after hearing bad news. It’s known as broken heart syndrome. While people who have broken heart syndrome usually recover, play it safe. If a loved one complains of chest pain after a traumatic event, have him or her seek emergency medical care right away.
Nov. 13, 2019
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A positional headache is a type of headache that usually occurs when sitting or standing up and goes away fairly shortly after lying down. Positional headaches are also known as orthostatic, postural, and low pressure headaches.
Leaks of cerebrospinal fluid (CSF) are often the cause of positional headaches, but several other conditions can cause them. These include conditions that affect the connective tissues, bones, and nervous system.
This article covers the symptoms and causes of positional headaches, as well as the treatment options available.
Share on PinterestMost positional headaches cause pain that is worse when a person is upright and goes away after they lie flat for around 20–30 minutes.
Some people with positional headaches may wake up in the morning with a mild headache that gets worse throughout the day.
It is also not unusual for the positional nature of headaches to go away or become weaker over time.
Positional headaches tend to cause pain in the back of the head, though they can also affect the front of the head, just one side of it, or the entire head. People describe the pain associated with positional headaches as:
Certain actions and activities can make headache symptoms worse. These include:
This section covers some specific causes of positional headaches.
The cause of a positional headache is often low spinal fluid pressure inside the head, which occurs in a condition called intracranial hypotension. Intracranial hypotension generally relates to a loss or imbalance of CSF.
CSF cushions the brain and spinal cord within special membranes called meninges. These meninges prevent the brain and spinal cord from coming into contact with boney structures during movement.
When something damages the meninges, it can allow CSF to leak into the body, lowering fluid volume and pressure.
This change in pressure can drop the position of the brain. This means that the brain is more likely to come into contact with pain-sensitive structures in the head or spine.
Most positional headaches develop while a person is sitting or standing upright. This is because a lot of circulating CSF surrounds the spinal cord, and when someone with reduced CSF levels is standing or sitting, their CSF levels reduce even further. This increases the risk of positional headache.
A doctor will normally rule out a CSF leak before looking into other potential causes.
Positional headaches can sometimes result from structural problems or conditions that impact parts of the neck, rather than head itself.
For example, the headache could develop due to problems with the:
This is a condition involving dysfunction of the autonomic nervous system, which regulates important processes such as heart function and fluid balance.
Postural orthostatic tachycardia syndrome (POTS) causes rapid heartbeat and blood pressure changes when the person is standing. It may develop after someone with a CSF leak or other debilitating condition has needed to remain lying down for a long period of time, such as due to hospitalization.
A doctor will typically rule out a CSF leak before testing for other conditions. They will do this by asking questions about the person’s symptoms, reviewing their medical history, and ordering diagnostic tests.
Some tests that doctors can use to detect CSF leaks include MRI scans and CT myelography scans.
MRI scans use strong magnetic fields to create an image that reveals typical CSF leak patterns in around 80% of cases. CT myelography scans, meanwhile, use special X-rays and contrasting dye to create detailed images that can reveal damage, abnormalities, or leaks.
To rule out POTS, a doctor may also order a Trendelenburg test. This involves the person lying flat on an exam table that alternates between being horizontal and lowering the head. During this test, a doctor will monitor the person’s heart rate and blood pressure.
The best treatment option for positional headaches depends on the underlying cause.
Treatments for CSF leaks vary based on their severity and the location of the leak.
Mild-to-moderate CSF cases may respond to a range of lifestyle remedies, including:
However, some mild-to-moderate CSF symptoms may get better without any treatment.
Certain medications can also help manage the symptoms of CSF leaks.
However, researchers are yet to prove the effectiveness of most of these. In fact, some of these medications may carry serious health risks, including disability.
Some medications for CSF leak symptoms include:
People with CSF leaks may also need to undergo an epidural blood patch (EBP). This is a procedure wherein a doctor injects 10–100 milliliters of a person’s own blood into the epidural space in their spinal canal.
This creates a patch on the outer layer of the meninges, which seems to reduce CSF loss.
A doctor will perform an EBP procedure at the location of a leak, or in the middle or lower parts of the spine if they do not know the exact location of the leak.
Health professionals do not know exactly why this procedure seems to help manage CSF leaks. However, at the very least, it seems to help relieve symptoms and confirm the diagnosis.
People should try to avoid strenuous activities or bending over for 4–6 weeks after undergoing an EBP procedure.
Blood patching usually brings instant relief of symptoms, but its effect can wear off, causing the need for multiple procedures.
In severe or chronic cases, or when the precise location of the leak is known, doctors may perform surgery. The type and extent of the surgery depends on individual factors.
Several different types of surgery may be necessary to remove or repair structural abnormalities or abnormal growths, such as tumors, malformations, or cysts.
There is no cure for POTS. However, increasing blood volume and helping regulate circulatory conditions can help.
Some medications and lifestyle changes that may assist in this include:
It is difficult to reduce the risk of positional headaches, apart from by practicing good safety, sticking to healthful habits, and addressing any underlying health conditions.
There are several different factors that can increase the risk of developing a CSF leak, which is a common cause of positional headaches. These include:
For the conditions that cause positional headaches, receiving an early diagnosis and prompt treatment usually reduces the risk of serious complications.
See a doctor as soon as possible or seek emergency care if any warning signs of CSF leaks or POTS accompany positional headaches.
Some warning signs of a CSF leak include:
Positional headaches usually occur while a person is standing or sitting upright and improve when they lie down. Only a few conditions can cause them, most notably CSF leaks and POTS.
Some CSF leaks resolve without treatment, whereas others require lifestyle changes, medications, EBP procedures, or surgical repairs.
Treatments for most CSF leaks tend to be successful, but some people may continue to have symptoms and disability after several treatments.
There is no cure for POTS, but people can manage it by making lifestyle changes and taking medication to control blood pressure and volume.
To reduce the risk of complications, speak to a doctor about any unexplained, chronic, or severe headaches, especially those that change with position.
Dandruff itself does not cause hair loss, but the two may be linked. This is because some infections and medical conditions can cause both dandruff and hair loss.
Dandruff is very common. People with dandruff and dandruff-like symptoms might lose hair, especially if the dandruff is severe.
The cause of the hair loss is not the dandruff itself. Instead, it is the cause of the dandruff that also leads to hair loss.
That said, severe dandruff may damage the scalp or hair follicles, causing hair to thin or stop growing.
Anyone who suspects that dandruff is causing hair loss should see a dermatologist to ensure that the problem is not something else.
This article looks at the link between dandruff and hair loss, prevention, and when to see a doctor.
Share on PinterestDandruff refers to the dry, itchy flakes of skin that develop on the scalp. It is a symptom, not a specific diagnosis.
Many factors can cause dandruff, such as dry skin, diet, stress, and some shampoos and hair products.
Dandruff itself does not cause hair loss. However, severe dandruff can cause a person to scratch their scalp so hard that they injure it.
Repeated inflammation in the hair follicles can cause damage and scarring, slowing or stopping hair growth. This can cause weak or thinning hair. Twisting the hair, aggressively brushing it, or scratching the scalp may make this type of hair loss worse.
Some medical conditions can also cause dandruff or flaky skin on the scalp, including seborrheic dermatitis, eczema, scalp psoriasis, and scalp ringworm. Some of these conditions are also associated with hair loss.
Any condition that causes skin flakiness or makes the outer layer of skin shed at an unusually fast rate may cause dandruff.
If a person does not seek treatment, these conditions may also damage the scalp and cause hair loss.
The following conditions can cause both dandruff and hair loss:
Any condition that causes the scalp to itch or burn may cause hair loss when a person scratches their scalp or twists their hair. Children in particular may respond to scalp pain by pulling the hair.
In people with both dandruff and hair loss, there is no guarantee that the two are linked. Some people may have dandruff, perhaps due to dry skin, as well as a condition that causes hair loss, such as:
People with a history of dandruff may experience occasional flares of dandruff, even after successfully treating it.
The following are some strategies that can prevent dandruff-related hair loss:
Some people may find that their dandruff shampoo leaves the hair dull or dry. Dry, damaged hair breaks more easily and may fall out. Use a high quality conditioner after dandruff treatment.
If the damage persists, try alternating dandruff shampoo with another shampoo.
Dandruff is very common, and most people are able to manage the symptoms with home treatment.
People with dandruff are unlikely to lose their hair. However, untreated dandruff may be a culprit in hair loss. Even when dandruff is not the primary cause, it may damage the scalp and accelerate hair loss due to other causes.
Numerous conditions can mimic the symptoms of dandruff. If dandruff does not get better with home treatment, if the itching becomes intolerable, or if the hair continues to fall out, see a dermatologist.
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