Differential Diagnosis for Pregnancy-Related Headache
- Single most likely diagnosis
- Tension headache: This is the most likely diagnosis given the context of the question, which mentions "pregnancy tension headache." Tension headaches are common during pregnancy due to hormonal changes, stress, and fatigue.
- Other Likely diagnoses
- Migraine: Migraines can occur or worsen during pregnancy, especially in the first trimester, due to hormonal fluctuations. They are characterized by severe, unilateral headaches often accompanied by nausea, vomiting, and sensitivity to light and sound.
- Sinus headache: Sinus pressure and congestion can lead to headaches during pregnancy, possibly due to increased blood volume and mucous production.
- Cervicogenic headache: These headaches originate from the cervical spine and can be exacerbated by the postural changes and increased weight associated with pregnancy.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Preeclampsia: A condition characterized by high blood pressure and often accompanied by protein in the urine, occurring after the 20th week of pregnancy. Headaches can be a symptom, and it's crucial to diagnose and manage preeclampsia promptly to prevent severe complications.
- Posterior reversible encephalopathy syndrome (PRES): A rare but serious condition associated with preeclampsia, characterized by headaches, vision changes, and seizures, due to brain edema.
- Subarachnoid hemorrhage or other intracranial hemorrhages: Although rare, these conditions can present with a sudden, severe headache and are medical emergencies requiring immediate attention.
- Rare diagnoses
- Idiopathic intracranial hypertension (IIH): Also known as pseudotumor cerebri, this condition involves increased pressure within the skull without a detectable cause, leading to headaches and vision problems. It can occur in pregnancy, particularly with weight gain.
- Arteriovenous malformation (AVM) or cerebral aneurysm: These vascular abnormalities can cause headaches and, if ruptured, lead to severe neurological consequences. They are rare but critical to identify due to their potential for catastrophic outcomes.