Head feels like it will explode daily. Severe cognitive difficulties

Thank you for responding. It means a lot. Being able to talk to someone who actually listens really helps.

The symptoms started out as occasional brain fog around a year ago. It was odd, as I could sometimes tell the brain fog came from the back of my head. Eventually, the brain fog became constant. I thought my ADHD meds stopped working, so I started keeping track of those.

This summer the symptoms advanced, now the back of my head often feels under pressure with the constant brain fog. Then I knew there was no way this was my meds (since I wasn’t taking them during summer).

I have only been able to talk to my doctor once about the issue, as he retired. He believed it to be depression. I believe the issue caused that, but that it’s separate from my issue. I’ve started therapy around a week ago.

I’ve talked with a nurse practitioner three times. They order multiple blood tests and refer me to different people (neurologist, hematologist, and a rheumatologist for some reason).

I have been to a neurologist twice. They tell me it’s just migraines. The meds they give me don’t work. Nurse practitioner agrees it’s just migraines. I feel my opinion + symptoms is disregarded by both.

I’ve gotten several blood tests checking for possible headache causes. Magnesium, testosterone, vitamin B, vitamin D, Iron, thyroid, and a couple others I can’t recall. My brain MRI comes up negative.

I tried a chiropractor, but I only went for a couple meetings since I’m rather skeptical of chiropractors. No change in my symptoms.

Next thing I plan on trying is occipital nerve blocks from the neurologist. Since my symptoms seem to come from the back of the head, it could be some weird case of Occipital Neuralgia (weird in that it isn’t painful, only feels like pressure). I’ve talked with someone online who has ON and ADHD. Just like me, they experienced brain fog first and thought their medication stopped working before they got any other symptoms. Also, they could tell their brain fog came from the back of the head too.

If the nerve blocks work, I’ll consider further steps. If they don’t work, I might try to get imaging of my cervical spine and, if any issues are spotted, get them solved through physical therapy or other means.

Thank you. I will try to give updates as best I can.

October 1 2020 cxvid hit me. Since then 24 x 7 headaches and migraine with auras, pressure on brain (atmospheric pressure relate), brain on fire, brain fog, dizzy, tension headaches (PT Dry Needling fixed) blah blah blah

My head pain/ symptoms puzzle has many pieces.
The last year I’ve been working with Neurology and now I’m looking to add working with Immunology (cell level).

Here are a few papers I’ve found recently that are making sense.
Papers -
12/11/2024 - Persistence of spike protein at the skull-meninges-brain axis may contribute to the neurological sequelae of COVID-19 (Graphic abstract very interesting)
8/16/2025 Comparative Analysis of Long COVID and Post-Vaccination Syndrome:
2/19/2025 - A small number of people report chronic symptoms after receiving COVID-19 shots. A new study provides clues for further research.
10/19/2023 (video) Harlan Krumholz and Akiko Iwasaki (Rishi Shiah, Lilo Wu, and Adith Arun) discuss preliminary findings and answer questions from LISTEN participants.
I listed the Symptoms Long Covid – PVS post-vaccination syndrome (very interesting)
8/25/2025 Immunologist: Hope for ME/CFS and post-Covid, research needed
Akiko Iwasaki "... She sharply rejected views that ME/CFS or post-COVID might not be somatic illnesses."
2/19/2025 - A small number of people report chronic symptoms after receiving COVID-19 shots. A new study provides clues for further research.

12/11/2024 - Persistence of spike protein at the skull-meninges-brain axis may contribute to the neurological sequelae of COVID-19
https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(24)00438-4
Highlights
SARS-CoV-2 spike protein persists in the skull-meninges-brain axis in COVID-19 patients
Spike protein is sufficient to induce brain pathological and behavioral changes in mice
Spike protein enhances brain vulnerability and exacerbates neurological damage in mice
mRNA vaccines reduce, but do not eliminate, the spike burden

Summary
SARS-CoV-2 infection is associated with long-lasting neurological symptoms, although the underlying mechanisms remain unclear. Using optical clearing and imaging, we observed the accumulation of SARS-CoV-2 spike protein in the skull-meninges-brain axis of human COVID-19 patients, persisting long after viral clearance. Further, biomarkers of neurodegeneration were elevated in the cerebrospinal fluid from long COVID patients, and proteomic analysis of human skull, meninges, and brain samples revealed dysregulated inflammatory pathways and neurodegeneration-associated changes. Similar distribution patterns of the spike protein were observed in SARS-CoV-2-infected mice. Injection of spike protein alone was sufficient to induce neuroinflammation, proteome changes in the skull-meninges-brain axis, anxiety-like behavior, and exacerbated outcomes in mouse models of stroke and traumatic brain injury. Vaccination reduced but did not eliminate spike protein accumulation after infection in mice. Our findings suggest persistent spike protein at the brain borders may contribute to lasting neurological sequelae of COVID-19.
Graphic abstract - Click paper link for graphics – very interesting

8/16/2025 Comparative Analysis of Long COVID and Post-Vaccination Syndrome:
https://www.medrxiv.org/content/10.1101/2025.08.14.25333639v1
“Question - What are the similarities and differences between long COVID and post-vaccination syndrome (PVS)?

Findings In this cross-sectional study of 682 individuals, machine learning models identified distinct symptoms between long COVID and PVS. Long COVID was characterized by brain fog, altered sense of smell, and shortness of breath, while PVS was associated with burning sensations, neuropathy, and numbness.”

Feb 19, 2025 - A small number of people report chronic symptoms after receiving COVID-19 shots. A new study provides clues for further research.
https://news.yale.edu/2025/02/19/immune-markers-post-vaccination-syndrome-indicate-future-research-directions
“COVID-19 vaccines have been instrumental in reducing the impact of the pandemic, preventing severe illness and death, and they appear to protect against long COVID. However, some individuals have reported chronic symptoms that developed soon after receiving a COVID-19 vaccine. This little-understood, persistent condition, referred to as post-vaccination syndrome (PVS), remains unrecognized by medical authorities, and little is known about its biological underpinnings.”
(click link to read more)

10/19/2023 Harlan Krumholz and Akiko Iwasaki (Rishi Shiah, Lilo Wu, and Adith Arun) discuss preliminary findings and answer questions from LISTEN participants.
https://medicine.yale.edu/ycci/listen-study/video/
The Yale LISTEN Study Town Hall: October 2023

The entire Town Hall is very interesting, here are 4 sections I found enlightening.

8:00 minute - Difference in Percent of Participants Experiencing Symptom (Long Covid – PVS post-vaccination syndrome; Note: the graphic chart is informative)

Long Covid –

Memory problems, Changed sense of smell, Brain fog, Shortness of breath, Cough, Sore throat, Excessive fatigue, Difficulty speaking properly, Changed sense of taste, Fatigue, Congested or runny nose, Phantom smells, Runny nose, Phlegm in back of throat, Headache, Constant thirst, Night sweats, Hypersomnia, Confusion, Insomnia, Hair loss, Dry scalp or dandruff, Dizziness, Throat pain or discomfort, Postnasal drip, Exercise Intolerance, Wheezing, Swollen hands or feet, Cold/burning lung sensation, Changes in voice, Phantom tastes

PVS -
Loss of hearing, Suicidal thoughts, Feelings of impending doom, Palpitations, Tinnitus, Numbness, Internal vibration, Neuropathy, Burning sensations

16:00 minute - Implications
18:33 minute - Hypothesis
37:00 minute - Hope next 6 months

(continue)

This is my second post on this subject. I wanted to share some more details on the matter to see if I can get anymore direction/advice.For over a year, I have been dealing with constant head pressure in the back of my head. Sometimes my head aches along with the pressure, and my eyes frequently ache as well, thus weakening my vision. With these head issues come extreme cognitive setbacks. I feel like I have forgotten much of the past, and I can hardly think because I have to try and think through pain and this sludgy head pressure. My head feels like it will explode 24/7. In addition to head/brain symptoms are digestive issues, on-and-off anxiety with no rhyme or reason to it, breathlessness when I talk, and achy limbs. Another thing about the head pressure situation is that it just feels like I can't emotionally connect with anything (like depersonalization maybe?). It doesn't feel like I have the capacity to feel any joy whatsoever. I never experience a complete sense of relief or relaxation. In other words, life is hell and I cannot enjoy it. I can't really get out and do much either thanks to the extreme head symptoms. All in all, life is a huge mental struggle where I am fighting for the will to keep going. I WILL keep going, but it's impossible to ignore the hell I am currently dealing with.I have fallen on my back while wearing a drum once about 3 years ago. Other than that, no injuries. I have plans to see a neurology department somewhat near me (if they get back with me). I have already seen 2 neurologists who weren't of any help. Muscle relaxants, antidepressants, pain killers/migraine medication, and numerous supplements have already been tried and were little to no use. I have seen numerous other doctors (functional medicine, PCP, ENT, etc.) along with 2 ER visits and haven't gotten anywhere. A supine MRI of my brain showed no abnormalities either.I am just fearful of my life. I haven't considered a spinal leak issue yet, although I don't get any relief when I lay down. I could also consider pursuing a cardiologist for blood flow to the brain issues, but I don't really know where to go from here. I just wish my poor brain function (lack of emotions, poor memory, weaker vision) made sense. I don't know if there's anything else that could be contributing to my symptoms?

October 1 2020 cxvid hit me. Since then 24 x 7 headaches and migraine with auras, pressure on brain (atmospheric pressure relate), brain on fire, brain fog, dizzy, tension headaches (PT Dry Needling fixed) blah blah blah

My head pain/ symptoms puzzle has many pieces.
The last year I’ve been working with Neurology and now I’m looking to add working with Immunology (cell level).

Here are a few papers I’ve found recently that are making sense.
Papers -
12/11/2024 - Persistence of spike protein at the skull-meninges-brain axis may contribute to the neurological sequelae of COVID-19 (Graphic abstract very interesting)
8/16/2025 Comparative Analysis of Long COVID and Post-Vaccination Syndrome:
2/19/2025 - A small number of people report chronic symptoms after receiving COVID-19 shots. A new study provides clues for further research.
10/19/2023 (video) Harlan Krumholz and Akiko Iwasaki (Rishi Shiah, Lilo Wu, and Adith Arun) discuss preliminary findings and answer questions from LISTEN participants.
I listed the Symptoms Long Covid – PVS post-vaccination syndrome (very interesting)
8/25/2025 Immunologist: Hope for ME/CFS and post-Covid, research needed
Akiko Iwasaki "... She sharply rejected views that ME/CFS or post-COVID might not be somatic illnesses."
2/19/2025 - A small number of people report chronic symptoms after receiving COVID-19 shots. A new study provides clues for further research.

12/11/2024 - Persistence of spike protein at the skull-meninges-brain axis may contribute to the neurological sequelae of COVID-19
https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(24)00438-4
Highlights
SARS-CoV-2 spike protein persists in the skull-meninges-brain axis in COVID-19 patients
Spike protein is sufficient to induce brain pathological and behavioral changes in mice
Spike protein enhances brain vulnerability and exacerbates neurological damage in mice
mRNA vaccines reduce, but do not eliminate, the spike burden

Summary
SARS-CoV-2 infection is associated with long-lasting neurological symptoms, although the underlying mechanisms remain unclear. Using optical clearing and imaging, we observed the accumulation of SARS-CoV-2 spike protein in the skull-meninges-brain axis of human COVID-19 patients, persisting long after viral clearance. Further, biomarkers of neurodegeneration were elevated in the cerebrospinal fluid from long COVID patients, and proteomic analysis of human skull, meninges, and brain samples revealed dysregulated inflammatory pathways and neurodegeneration-associated changes. Similar distribution patterns of the spike protein were observed in SARS-CoV-2-infected mice. Injection of spike protein alone was sufficient to induce neuroinflammation, proteome changes in the skull-meninges-brain axis, anxiety-like behavior, and exacerbated outcomes in mouse models of stroke and traumatic brain injury. Vaccination reduced but did not eliminate spike protein accumulation after infection in mice. Our findings suggest persistent spike protein at the brain borders may contribute to lasting neurological sequelae of COVID-19.
Graphic abstract - Click paper link for graphics – very interesting

8/16/2025 Comparative Analysis of Long COVID and Post-Vaccination Syndrome:
https://www.medrxiv.org/content/10.1101/2025.08.14.25333639v1
“Question - What are the similarities and differences between long COVID and post-vaccination syndrome (PVS)?

Findings In this cross-sectional study of 682 individuals, machine learning models identified distinct symptoms between long COVID and PVS. Long COVID was characterized by brain fog, altered sense of smell, and shortness of breath, while PVS was associated with burning sensations, neuropathy, and numbness.”

Feb 19, 2025 - A small number of people report chronic symptoms after receiving COVID-19 shots. A new study provides clues for further research.
https://news.yale.edu/2025/02/19/immune-markers-post-vaccination-syndrome-indicate-future-research-directions
“COVID-19 vaccines have been instrumental in reducing the impact of the pandemic, preventing severe illness and death, and they appear to protect against long COVID. However, some individuals have reported chronic symptoms that developed soon after receiving a COVID-19 vaccine. This little-understood, persistent condition, referred to as post-vaccination syndrome (PVS), remains unrecognized by medical authorities, and little is known about its biological underpinnings.”
(click link to read more)

10/19/2023 Harlan Krumholz and Akiko Iwasaki (Rishi Shiah, Lilo Wu, and Adith Arun) discuss preliminary findings and answer questions from LISTEN participants.
https://medicine.yale.edu/ycci/listen-study/video/
The Yale LISTEN Study Town Hall: October 2023

The entire Town Hall is very interesting, here are 4 sections I found enlightening.

8:00 minute - Difference in Percent of Participants Experiencing Symptom (Long Covid – PVS post-vaccination syndrome; Note: the graphic chart is informative)

Long Covid –

Memory problems, Changed sense of smell, Brain fog, Shortness of breath, Cough, Sore throat, Excessive fatigue, Difficulty speaking properly, Changed sense of taste, Fatigue, Congested or runny nose, Phantom smells, Runny nose, Phlegm in back of throat, Headache, Constant thirst, Night sweats, Hypersomnia, Confusion, Insomnia, Hair loss, Dry scalp or dandruff, Dizziness, Throat pain or discomfort, Postnasal drip, Exercise Intolerance, Wheezing, Swollen hands or feet, Cold/burning lung sensation, Changes in voice, Phantom tastes

PVS -
Loss of hearing, Suicidal thoughts, Feelings of impending doom, Palpitations, Tinnitus, Numbness, Internal vibration, Neuropathy, Burning sensations

16:00 minute - Implications
18:33 minute - Hypothesis
37:00 minute - Hope next 6 months

(continue)

This is my second post on this subject. I wanted to share some more details on the matter to see if I can get anymore direction/advice.For over a year, I have been dealing with constant head pressure in the back of my head. Sometimes my head aches along with the pressure, and my eyes frequently ache as well, thus weakening my vision. With these head issues come extreme cognitive setbacks. I feel like I have forgotten much of the past, and I can hardly think because I have to try and think through pain and this sludgy head pressure. My head feels like it will explode 24/7. In addition to head/brain symptoms are digestive issues, on-and-off anxiety with no rhyme or reason to it, breathlessness when I talk, and achy limbs. Another thing about the head pressure situation is that it just feels like I can't emotionally connect with anything (like depersonalization maybe?). It doesn't feel like I have the capacity to feel any joy whatsoever. I never experience a complete sense of relief or relaxation. In other words, life is hell and I cannot enjoy it. I can't really get out and do much either thanks to the extreme head symptoms. All in all, life is a huge mental struggle where I am fighting for the will to keep going. I WILL keep going, but it's impossible to ignore the hell I am currently dealing with.I have fallen on my back while wearing a drum once about 3 years ago. Other than that, no injuries. I have plans to see a neurology department somewhat near me (if they get back with me). I have already seen 2 neurologists who weren't of any help. Muscle relaxants, antidepressants, pain killers/migraine medication, and numerous supplements have already been tried and were little to no use. I have seen numerous other doctors (functional medicine, PCP, ENT, etc.) along with 2 ER visits and haven't gotten anywhere. A supine MRI of my brain showed no abnormalities either.I am just fearful of my life. I haven't considered a spinal leak issue yet, although I don't get any relief when I lay down. I could also consider pursuing a cardiologist for blood flow to the brain issues, but I don't really know where to go from here. I just wish my poor brain function (lack of emotions, poor memory, weaker vision) made sense. I don't know if there's anything else that could be contributing to my symptoms?

nathansmith7143

Sorry, this is a late reply, only just came across your post.
But I've been suffering very similar symptoms which started summer last year (started about a week after a fall) and as you described has been horrendous to live with. To cut a long story short, seen many doctors, consultants, ENT, CT scan, MRI nothing abnormal found. Out of desperation I went to see a chiropractor last October and for the first time made some progress with the symptoms. The chiropractor diagnosed as 'occipital neuralgia' - 'sub occipital trigger points' in the neck. Subsequent treatment has substantially reduced symptoms, although not yet totally symptom free. I also found using a neck stretcher brace for 10-15 minutes at a time helped.

Whilst the cause of my symptoms may be different, a chiropractor check is worth a try if you are still suffering. Note: my chiropractor has only used gentle therapy to treat this condition (no neck cracking!).

Hello, @aw1, and welcome to Mayo Clinic Connect. Sorry to hear your symptoms have been horrendous to live with.

Thanks for the suggestions for @nathansmith7143.

You may also want to check our these Mayo Clinic Connect discussions on occipital neuralgia:

- Occipital Neuralgia Relief https://connect.mayoclinic.org/discussion/occipital-neuralgia-relief/

- Occipital Neuralgia dizziness and vertigo https://connect.mayoclinic.org/discussion/occipital-neuralgia-dizziness-and-vertigo/

This is my second post on this subject. I wanted to share some more details on the matter to see if I can get anymore direction/advice.For over a year, I have been dealing with constant head pressure in the back of my head. Sometimes my head aches along with the pressure, and my eyes frequently ache as well, thus weakening my vision. With these head issues come extreme cognitive setbacks. I feel like I have forgotten much of the past, and I can hardly think because I have to try and think through pain and this sludgy head pressure. My head feels like it will explode 24/7. In addition to head/brain symptoms are digestive issues, on-and-off anxiety with no rhyme or reason to it, breathlessness when I talk, and achy limbs. Another thing about the head pressure situation is that it just feels like I can't emotionally connect with anything (like depersonalization maybe?). It doesn't feel like I have the capacity to feel any joy whatsoever. I never experience a complete sense of relief or relaxation. In other words, life is hell and I cannot enjoy it. I can't really get out and do much either thanks to the extreme head symptoms. All in all, life is a huge mental struggle where I am fighting for the will to keep going. I WILL keep going, but it's impossible to ignore the hell I am currently dealing with.I have fallen on my back while wearing a drum once about 3 years ago. Other than that, no injuries. I have plans to see a neurology department somewhat near me (if they get back with me). I have already seen 2 neurologists who weren't of any help. Muscle relaxants, antidepressants, pain killers/migraine medication, and numerous supplements have already been tried and were little to no use. I have seen numerous other doctors (functional medicine, PCP, ENT, etc.) along with 2 ER visits and haven't gotten anywhere. A supine MRI of my brain showed no abnormalities either.I am just fearful of my life. I haven't considered a spinal leak issue yet, although I don't get any relief when I lay down. I could also consider pursuing a cardiologist for blood flow to the brain issues, but I don't really know where to go from here. I just wish my poor brain function (lack of emotions, poor memory, weaker vision) made sense. I don't know if there's anything else that could be contributing to my symptoms?

Have you had imaging down on your neck? Thinking about how my cervical problems give me a dull headache almost constantly. But I also get migraines which I am using Aimovig injection, it has been life changing. One more thing, i sincerely hope you find answers, chronic pain even if not severe is really tough to cope with.

@im70

Aimovig for migraines? Ill like some info please