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 severe, unilateral, throbbing headaches, often accompanied by nausea, vomiting, and sensitivity to light and sound. Migraines can be triggered by various factors, including hormonal changes, certain foods, and stress.
  • Sinus headache: Caused by inflammation or infection of the sinuses, leading to pain and pressure in the cheeks, forehead, and nose. It's often accompanied by other symptoms like nasal congestion, fever, and facial tenderness.
  • Cluster headache: Known for its severe, unilateral pain, typically centered around one eye, with associated symptoms like nasal congestion, rhinorrhea, and ptosis. Cluster headaches occur in cyclical patterns or clusters.
• 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. Symptoms include severe headache, fever, stiff neck, and altered mental status.
  • Temporal arteritis: Inflammation of the blood vessels in the temples, which can lead to blindness if not treated promptly. It's characterized by a severe, unilateral headache, jaw claudication, and visual disturbances, primarily affecting individuals over 50 years old.
• 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.
  • Idiopathic intracranial hypertension (IIH): Characterized by increased pressure within the skull without any apparent cause, leading to symptoms like headache, vision changes, and tinnitus.
  • Hypnic headache: A rare type of headache that occurs exclusively during sleep and wakes the patient, typically occurring in older adults.