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.