Differential Diagnosis for Continuous Headache for a Few Days
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. The continuous nature for a few days could be due to prolonged stress, poor posture, or other factors that exacerbate muscle tension.
Other Likely Diagnoses
- Migraine: Although typically episodic, migraines can occasionally present as a continuous headache, especially if the patient is experiencing a prolonged aura phase or if the headache is not adequately treated. Migraines are often unilateral, throbbing, and accompanied by sensitivity to light, sound, or nausea.
- Sinusitis: Inflammation of the sinuses can cause a continuous headache, typically felt in the facial area, and is often accompanied by other symptoms such as nasal congestion, fever, and facial pressure.
- Medication overuse headache: Frequent or excessive use of headache medications can lead to a condition where the body becomes dependent on these drugs to suppress headache pain, resulting in a continuous or worsening headache pattern.
Do Not Miss Diagnoses
- Subarachnoid hemorrhage: Although less common, a sudden onset of a severe headache (often described as "the worst headache of my life") could indicate bleeding into the space surrounding the brain. This is a medical emergency requiring immediate attention.
- Meningitis: Infection of the meninges, the protective membranes covering the brain and spinal cord, can cause a severe, continuous headache, along with fever, stiff neck, and sensitivity to light.
- Temporal arteritis: An inflammation of the blood vessels in the head, particularly affecting the temporal artery, can cause a continuous, severe headache, often accompanied by jaw claudication and visual disturbances. This condition requires prompt treatment to prevent blindness.
- Brain tumor: Although rare, a continuous headache could be a symptom of a brain tumor, especially if accompanied by other neurological symptoms such as seizures, confusion, or focal neurological deficits.
Rare Diagnoses
- Idiopathic intracranial hypertension (IIH): A condition characterized by increased pressure within the skull without any apparent cause, leading to a continuous headache, often accompanied by vision changes and tinnitus.
- Hypnic headache: A rare type of headache that occurs only during sleep and wakes the patient, typically occurring in older adults.
- Hemicrania continua: A rare, continuous, one-sided headache that can vary in severity and is often accompanied by autonomic symptoms such as nasal congestion or eye watering on the same side as the headache.