Differential Diagnosis for Non-Specific Headache
- Single Most Likely Diagnosis
- Tension Headache: This is the most common type of headache and is often described as a band or a squeezing sensation around the forehead, usually mild to moderate in intensity. The high prevalence of tension headaches in the general population makes it the single most likely diagnosis for non-specific headache.
- Other Likely Diagnoses
- Migraine: Characterized by severe, throbbing pain, often unilateral and accompanied by nausea, vomiting, and sensitivity to light and sound. Migraines are common and can present with varying degrees of severity, making them a likely consideration.
- Cluster Headache: Although less common than migraines or tension headaches, cluster headaches are extremely painful and occur in cyclical patterns or clusters, often waking the patient from sleep. Their distinctive pattern and severe pain make them a notable differential.
- Sinus Headache: Caused by inflammation or infection of the sinuses, these headaches are often accompanied by facial pain, nasal congestion, and fever. Given the commonality of sinus infections, sinus headaches are a plausible diagnosis.
- Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: A life-threatening condition caused by bleeding into the space surrounding the brain, often presenting with a sudden, severe headache (often described as "the worst headache of my life"). Although rare, the potential for high morbidity and mortality makes it crucial not to miss.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, usually due to infection. Symptoms can include headache, fever, and stiff neck. The severity and potential for serious complications necessitate its inclusion as a "do not miss" diagnosis.
- Temporal Arteritis: An inflammation of the blood vessels in the head, more common in older adults. It can lead to blindness if not treated promptly. The potential for severe and irreversible consequences if missed makes it a critical differential.
- Brain Tumor: Although rare, a brain tumor can cause headaches, often worse in the morning and accompanied by nausea and vomiting. The severity of this diagnosis and its implications for patient outcomes justify its inclusion in the "do not miss" category.
- Rare Diagnoses
- Idiopathic Intracranial Hypertension (IIH): Characterized by increased pressure within the skull without a detectable cause, often presenting with headache and vision changes. Its relative rarity compared to other headache causes places it in this category.
- Hypnic Headache: A rare headache disorder that occurs only during sleep and wakes the patient, typically in older adults. The distinctive pattern and low frequency of occurrence make it a rare but interesting differential.
- Thunderclap Headache: An extremely severe headache that reaches its maximum intensity within a minute, often indicative of a subarachnoid hemorrhage but can have other causes. While the severity suggests it could be a "do not miss," its inclusion here reflects the broader differential of thunderclap headaches beyond just subarachnoid hemorrhage.