Differential Diagnosis for Headache and Vomiting after Playing a Game

Single Most Likely Diagnosis

• Dehydration or Heat-Related Illness: This is a common issue, especially if the game was physically demanding and played in a hot environment without adequate hydration. The symptoms of headache and vomiting can be directly related to dehydration or heat exhaustion.

Other Likely Diagnoses

• Migraine or Tension Headache: Playing games, especially video games, can lead to prolonged screen time, poor posture, and stress, all of which can trigger migraines or tension headaches. Vomiting can sometimes accompany severe migraines.
• Eye Strain: Prolonged use of digital devices can cause eye strain, leading to headaches. While vomiting is less common, severe eye strain could potentially contribute to nausea.
• Stress or Anxiety: Participating in competitive games can cause significant stress or anxiety, which might lead to physical symptoms like headaches and vomiting.

Do Not Miss Diagnoses

• Subarachnoid Hemorrhage or Other Intracranial Hemorrhages: Although rare, a sudden, severe headache (often described as "the worst headache of my life") accompanied by vomiting could be indicative of a subarachnoid hemorrhage, which is a medical emergency.
• Meningitis: Infection leading to meningitis could present with headache and vomiting, among other symptoms like fever and neck stiffness. It's crucial to identify and treat promptly.
• Concussion or Traumatic Brain Injury: If the game involved physical activity, a concussion could be a cause of headache and vomiting, especially if there was a blow to the head.

Rare Diagnoses

• Idiopathic Intracranial Hypertension (IIH): This condition involves increased pressure within the skull without a detectable cause. It can lead to headaches and vomiting, but it's relatively rare and often associated with other symptoms like vision changes.
• Chiari Malformation: A structural defect in the cerebellum that controls balance can cause headaches and vomiting, especially after activities that increase intracranial pressure, like coughing or straining. However, this would be an unusual direct consequence of playing a game unless the game involved such physical exertions.