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Differential Diagnosis for Chronic Headaches

Single Most Likely Diagnosis

  • Tension-Type 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 chronic nature of the headaches and the lack of specific details pointing towards other conditions make this a likely diagnosis.

Other Likely Diagnoses

  • Migraine: A common cause of chronic headaches, characterized by severe, unilateral, throbbing pain, often accompanied by nausea, vomiting, and sensitivity to light and sound.
  • Chronic Daily Headache: Includes a variety of headache disorders that occur 15 days or more per month, such as chronic migraine, chronic tension-type headache, and new daily persistent headache.
  • Medication Overuse Headache: Frequent or excessive use of headache medications can lead to rebound headaches, creating a cycle of headache and medication overuse.

Do Not Miss Diagnoses

  • Subarachnoid Hemorrhage: Although less common, this condition is life-threatening and requires immediate medical attention. It typically presents with a sudden, severe headache (often described as "the worst headache of my life").
  • Giant Cell Arteritis: An inflammatory condition affecting the blood vessels, particularly in individuals over 50, which can lead to blindness if not promptly treated. Symptoms include headache, scalp tenderness, jaw claudication, and visual disturbances.
  • Brain Tumor: A mass in the brain that can cause increased intracranial pressure, leading to headaches, often worse in the morning and exacerbated by coughing or straining.
  • Idiopathic Intracranial Hypertension: Characterized by increased pressure within the skull without a detectable cause, leading to headaches, vision changes, and sometimes papilledema.

Rare Diagnoses

  • Trigeminal Neuralgia: A chronic pain condition that affects the trigeminal nerve, causing intense shock-like or stabbing pain in parts of the face.
  • Hemicrania Continua: A rare headache disorder characterized by a continuous, often severe, headache on one side of the face, with periods of exacerbation.
  • Cervicogenic Headache: Originates from the cervical spine and is typically felt on one side of the head, often accompanied by neck pain and limited range of motion.
  • Temporal Arteritis: Similar to giant cell arteritis but typically affects smaller branches of the external carotid artery, leading to headache, jaw claudication, and sometimes visual symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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