Differential Diagnosis for 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 accompanied by muscle tension in the neck and scalp. It's typically bilateral, mild to moderate in severity, and can be related to stress, poor posture, or fatigue.
• Other Likely Diagnoses
  • Migraine: Characterized by recurrent episodes of severe headaches, often unilateral and pulsating, accompanied by nausea, vomiting, and sometimes aura symptoms. Migraines can be triggered by various factors including hormonal changes, certain foods, and stress.
  • Cluster headache: Known for severe, unilateral orbital or periorbital pain, typically occurring in clusters or cycles, with accompanying autonomic symptoms like nasal congestion or lacrimation. These headaches are less common but very distinctive.
  • Sinus headache: Caused by inflammation or infection of the sinuses, leading to pain and pressure in the facial area, often accompanied by nasal congestion, fever, and cough.
• Do Not Miss Diagnoses
  • Subarachnoid hemorrhage: A life-threatening condition caused by bleeding into the space surrounding the brain, leading to a sudden, severe headache often described as "the worst headache of my life." It requires immediate medical attention.
  • Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, usually due to infection, presenting with headache, fever, stiff neck, and potentially life-threatening if not promptly treated.
  • Temporal arteritis: Inflammation of the blood vessels in the head, particularly affecting the temporal artery, leading to headache, jaw claudication, and visual disturbances. If untreated, it can cause blindness.
  • Brain tumor: Although rare, headaches can be a symptom of brain tumors, especially if they are large enough to cause increased intracranial pressure or if they exert pressure on specific areas of the brain.
• 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.
  • Hypnic headache: A rare headache disorder that occurs only during sleep and wakes the patient up, typically occurring in older adults.
  • 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 as well.
  • Idiopathic intracranial hypertension (IIH): A condition characterized by increased pressure within the skull without any apparent cause, leading to headaches, vision changes, and sometimes tinnitus.