Headache then short term memory loss

[Skeg]

My brother just decided to lift again (in his basement, never had any coaching). 64 years old, 5 ft 3 in, 140 lbs. He was benching around 105 lbs. He says he takes a deep breath, then slowly lets it out as he raises the bar. While raising the bar, he had a sharp pain in his head. No big deal, worked out a bit more and went upstairs to make lunch for work. He had to ask his wife four times what day it was, how old was food in the fridge that he had cooked the day before, and several other things.

Thoughts? Is this just an old guy thing from holding his breath, something else someone has seen before, a stroke? Related to the lifting or something else? In any case, his kids will kidnap him and forcibly take him to a neurologist, who I don't want him to believe when he says he can't life anymore.

Good news--Now he's open to coaching.

[Nick D'Agostino]

An acute headache followed and short term memory loss following bench pressing is very unusal and something that he should get checked out. It is not unusual for the 60+ population to experience orthostatic hypotension from a rapid position change (like getting up from lying down) but that is usually described with symptoms like feeling dizzy and light headedness that goes away after a couple of minutes. This presentation is not that. Let us know what the neurologist has to say.

[Matt James]

I agree with Nick. Neurological symptoms are not something to eff around with.

I had something similar happen many years ago, doing some extreme high range trombone playing on a gig. (It happens to trumpet players more often than bone players, but anyway...) In that case, it's thought to be caused by very high intraoral pressure that ends up cutting off blood supply to the brain, although whether it's due to compression of the carotid or elsewhere is kind of an open question. At any rate, I didn't lose consciousness but I did lose vision for a few moments, had an intense headache for a few days, and had some short term memory issues too. I ended up getting an MRI with contrast to rule out any bleeds (there were none), and ultimately reassessed my approach to high register playing.

The thing that concerns me about what you've described with your brother is that if he was actually exhaling through the lift, he wouldn't have been creating nearly that much internal pressure. So there very well may be some other pathology at work.

For the record, I've never experienced anywhere near that kind of pressure under a hard valsalva while lifting, although people occasionally report benign almost-blackouts when locking out the overhead press. Get him checked out!

[jfsully]

Get it checked out ASAP. Know what the diagnosis and recommendations are before you decide to ignore them!

[Skeg]

Thank you all for your comments. So far, my brother has been to the doctor who thinks it is "exercise induced migraine." The doctor told him he has seen this in weightlifters, rowers, runners, tennis players, swimmers and football players. That is, those who do these things in a strenuous fashion, not just goofing around. The doctor told him that those who have this will often experience an "aura" as the migraine begins, and then experience some confusion afterwards. He had something similar when he was younger and was working out by swimming. Next step is to get the MRI/scan to make sure there's not something else going on. Doctor told him that if this happens on a regular basis he can give him some medicine to take to control it. Thoughts? Comments?

[Skeg]

Sully, my brother lives in West Bloomfield and said he will be contacting you for some advice and help with his lifting.

[jfsully]

Sully, my brother lives in West Bloomfield and said he will be contacting you for some advice and help with his lifting.

I'm not "that" Sully. I am a different doctor with the same name. But seeking out Dr. Sullivan in MI is an excellent idea.

As far as this being a migraine, that is a pretty good call. If it continues to happen, and especially if it is worsening in severity or accompanies other symptoms (e.g. unilateral weakness), then yes, follow up with the doc to see if it is worth taking a preventative medication or if there is further workup to be done.

Migraine is one of those things that is "benign" in that it doesn't damage you, but it can really wreck your life if it is severe and/or frequent. If you can ride it out, or maybe take an abortive med once in a while when it's especially bad, that's good. If it happens often enough or is debilitating enough to be worth taking a daily med to keep it away, there are some options for that too. Every medication has potential side effects, so you have to weigh the +/- of course.