Differential Diagnosis for 28-year-old Female with Headache
- Single most likely diagnosis
- Tension headache: This is the most likely diagnosis given the patient's symptoms of frontal headache, nausea, and photophobia, which are common in tension headaches. The recent increase in screen time, quitting smoking, and increased stress also support this diagnosis, as these factors can contribute to tension headaches.
- Other Likely diagnoses
- Migraine: Although the patient denies a history of migraines, it's possible that this could be her first migraine episode. The symptoms of nausea, photophobia, and frontal headache are consistent with migraines.
- Eye strain headache: The patient's increased screen time and poor eye care (not having been to the eye doctor in a long time) could contribute to eye strain, leading to a headache.
- Dehydration headache: The patient's poor diet and possible inadequate hydration could lead to a dehydration 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's essential to consider subarachnoid hemorrhage, as it can present with sudden, severe headache and is a medical emergency.
- Cervical artery dissection: This is a rare but potentially life-threatening condition that can cause headache and neck pain.
- Temporal arteritis: This condition can cause headache, jaw claudication, and visual changes, although the patient denies visual changes.
- Rare diagnoses
- Cluster headache: This is a rare type of headache that can cause severe, unilateral pain and is often accompanied by autonomic symptoms.
- Idiopathic intracranial hypertension: This condition can cause headache, visual changes, and papilledema, although the patient denies visual changes.
- Sinus headache: Although the patient denies fever and other sinus symptoms, sinus headache is a possible diagnosis, especially if the patient has a history of sinusitis.