Differential Diagnosis for 25-year-old Female with Intermittent Headache
- Single most likely diagnosis:
- Tension headache or stress-related headache: The patient reports frequent headaches, and the current episode is described as frontal, radiating to the back, and associated with photophobia, but not the worst headache of her life. The recent onset of nausea and belly ache could be related to her menstrual cycle, which started today.
- Other Likely diagnoses:
- Migraine: Although the patient has never been diagnosed with migraines, her symptoms of photophobia, frontal headache radiating to the back, and nausea are consistent with migraine headaches.
- Sinus headache: The patient's symptoms of frontal headache and nausea could be related to a sinus infection or sinus pressure.
- Menstrual-related headache: The patient's headache started around the time of her menstrual cycle, which could suggest a hormonal component to her headache.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Subarachnoid hemorrhage: Although the patient denies the worst headache of her life, it is essential to consider this diagnosis due to the potential severity and risk of mortality.
- Meningitis: The patient's symptoms of headache, nausea, and photophobia could be indicative of meningitis, especially if she has a fever or other signs of infection.
- Pituitary apoplexy: This rare condition can cause sudden, severe headache, nausea, and visual disturbances, especially in pregnant or postpartum women, but can also occur in non-pregnant women.
- Rare diagnoses:
- Idiopathic intracranial hypertension (IIH): The patient's recent eye appointment and recommendation for glasses could be related to increased intracranial pressure, which is a characteristic of IIH.
- Temporal arteritis: Although rare in a 25-year-old, temporal arteritis can cause headache, nausea, and visual disturbances, especially if the patient has a history of autoimmune disorders.
- Brain tumor: A brain tumor can cause headache, nausea, and visual disturbances, especially if the tumor is located in the frontal or occipital lobe.