Differential Diagnosis for Headaches
The patient's complaint of headaches can be approached by considering various potential causes, categorized for clarity and emphasis on critical conditions.
- Single Most Likely Diagnosis
- Tension headache: This is the most common type of headache and is often related to stress, muscle tension, or poor posture. It's characterized by a band-like pressure around the forehead, back of the neck, or both.
- Other Likely Diagnoses
- Migraine: A neurological condition characterized by intense, debilitating headaches, often accompanied by nausea, vomiting, and sensitivity to light or sound.
- Sinus headache: Caused by inflammation or infection of the sinuses, leading to pain and pressure in the face and head.
- Cluster headache: A rare but severe type of headache that occurs in cycles or clusters, often waking the patient from sleep.
- 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.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, which can be caused by infection and is a medical emergency.
- Temporal arteritis: Inflammation of the blood vessels in the head, which can lead to blindness if not promptly treated.
- Brain tumor: Although rare, headaches can be a symptom of a brain tumor, especially if they are worsening over time or accompanied by other neurological symptoms.
- Rare Diagnoses
- Idiopathic intracranial hypertension (IIH): A condition characterized by increased pressure within the skull without any apparent cause, often presenting with headaches and vision changes.
- Trigeminal neuralgia: A chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain, causing intense shock-like or stabbing pain in parts of your face.
- Hypnic headache: A rare type of headache that occurs only during sleep and wakes the patient, typically occurring in older adults.
Each of these diagnoses has distinct characteristics and requires a thorough medical evaluation to determine the underlying cause of the patient's headaches.