Differential Diagnosis for a 9-Year-Old with Headaches
Single Most Likely Diagnosis
- Tension Headache: This is the most common type of headache in children, often characterized by a dull, aching pain on both sides of the head, and can be related to stress, poor posture, or muscle tension.
Other Likely Diagnoses
- Migraine: A common cause of headaches in children, migraines can be triggered by various factors such as stress, certain foods, or hormonal changes, and are often accompanied by symptoms like nausea, vomiting, and sensitivity to light or sound.
- Sinusitis: Inflammation or infection of the sinuses can cause headaches, especially if the child has a history of allergies or recent upper respiratory infections.
- Stress or Anxiety-Related Headache: Children can experience headaches due to stress or anxiety related to school, family, or social issues.
Do Not Miss Diagnoses
- Brain Tumor: Although rare, brain tumors can cause headaches, especially if they are worsening over time, occur at night, or are accompanied by other symptoms like vomiting, seizures, or changes in vision.
- Meningitis: Inflammation of the meninges (the protective membranes covering the brain and spinal cord) can cause severe headaches, fever, and stiff neck.
- Subarachnoid Hemorrhage: Bleeding into the space surrounding the brain can cause sudden, severe headaches, often described as "the worst headache of my life."
- Idiopathic Intracranial Hypertension (IIH): Increased pressure within the skull can cause headaches, vision changes, and other symptoms.
Rare Diagnoses
- Temporal Arteritis: Inflammation of the blood vessels in the temples can cause headaches, jaw pain, and vision changes, although it is more common in older adults.
- Pseudotumor Cerebri: A condition characterized by increased intracranial pressure without a detectable cause, which can cause headaches, vision changes, and other symptoms.
- Chiari Malformation: A congenital condition where the brain tissue extends into the spinal canal, which can cause headaches, especially after coughing, sneezing, or straining.