Differential Diagnosis for Unilateral Headache with Scalp Burning and Sensitivity

• Single most likely diagnosis
  • Migraine: This is often characterized by unilateral headaches, and some patients may experience scalp sensitivity or burning sensations, possibly due to the inflammation of blood vessels and nerves.
• Other Likely diagnoses
  • Cluster Headache: Known for severe, unilateral pain, often accompanied by autonomic symptoms. Scalp sensitivity could be part of the symptom complex.
  • Tension-Type Headache: While typically bilateral, some cases can present unilaterally, and scalp tenderness is a common feature.
  • Temporomandibular Joint (TMJ) Disorder: Can cause unilateral headache and facial pain, including scalp sensitivity due to referred pain from the jaw area.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Giant Cell Arteritis: A condition that can cause severe headache, scalp tenderness, and visual disturbances. It's crucial to diagnose early to prevent complications like blindness.
  • Temporal Arteritis: Similar to giant cell arteritis, it presents with headache and scalp sensitivity but is less common and can lead to serious complications if not treated promptly.
  • Meningitis: Although less common, meningitis can present with headache and scalp sensitivity, along with fever and neck stiffness. It's a medical emergency.
• Rare diagnoses
  • Trigeminal Neuralgia: Characterized by sudden, severe, shock-like pain around the eyes, lips, or nose mainly due to abnormal blood vessels pressing on the trigeminal nerve. It can cause unilateral pain but is less commonly associated with scalp burning.
  • Occipital Neuralgia: Involves inflammation or irritation of the occipital nerves, leading to pain in the back and side of the head, which could be mistaken for scalp burning or sensitivity.
  • Hemicrania Continua: A rare form of headache disorder that causes continuous, one-sided headache with autonomic features, which might include scalp sensitivity.