Is it normal for my head to feel heavy after a stroke?

A fellow caregiver asked...

I had a venous stroke 8 months ago and now my my head feels "heavy". All the recent head scans are negative. I'm not fatigued or sleepy. My head feels like it weighs a ton so I need to lay down. After I lay down, the heaviness is relieved. Is this normal?

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

To be honest, I have never heard of this specific complaint. However, venous strokes are rare enough that this may well be a long-term complication, and has just not been well described in the medical literature. If all of your scans are ok, I think this is a benign issue that should hopefully get better with time.

There are three possibilities that come to mind - although I cannot promise that any one of them is the cause of your symptoms. First, if you had a lumbar puncture when you went to the hospital, there could be a persistent cerebrospinal fluid leak that gives you these symptoms when you sit or stand. If you did have a lumbar puncture, I would discuss this possibility with your physician. Second, this may be a medication related effect. If your blood pressure drops too much on sitting or standing, it could cause you to feel light-headed or woozy. This would get better when lying flat. It might help to discuss this with your physician as well. Third, it may be that the clot in your cerebral vein is causing a pressure build-up in your head that somehow gets relieved when you lie down - possibly allowing venous blood to flow out of the head more smoothly. If this is the case, it should improve with time.

Sorry I do not have better answers for you, but I hope some of this helps.