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Last updated: September 18, 2025View editorial policy

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Differential Diagnosis for Headache and Vomiting

Single Most Likely Diagnosis

  • Viral Gastroenteritis: This is often the most common cause of headache and vomiting, especially if the symptoms are accompanied by fever, diarrhea, or abdominal cramps. The headache is usually a result of dehydration and the body's response to the infection.

Other Likely Diagnoses

  • Migraine: Migraines can cause severe headaches and are often accompanied by nausea and vomiting. They can be triggered by various factors, including stress, certain foods, or hormonal changes.
  • Tension Headache: While typically less severe than migraines, tension headaches can also lead to nausea and vomiting, especially if the pain is intense and persistent.
  • Gastroesophageal Reflux Disease (GERD): GERD can cause nausea and vomiting, and the discomfort or pain from acid reflux can lead to headaches.

Do Not Miss Diagnoses

  • Meningitis: Although less common, meningitis is a critical diagnosis that must not be missed. It presents with severe headache, fever, and vomiting, and can progress rapidly to seizures, coma, and death if not treated promptly.
  • Subarachnoid Hemorrhage: A sudden, severe headache (often described as "the worst headache of my life") accompanied by vomiting can be a sign of a subarachnoid hemorrhage, which is a life-threatening condition requiring immediate medical attention.
  • Increased Intracranial Pressure: Conditions that increase pressure inside the skull, such as a brain tumor or hydrocephalus, can cause headaches and vomiting. These conditions are medical emergencies.

Rare Diagnoses

  • Brain Abscess: A rare but serious condition where an abscess forms in the brain, causing headache, vomiting, and potentially severe neurological symptoms.
  • Encephalitis: Inflammation of the brain tissue, usually due to a viral infection, which can cause headache, vomiting, confusion, and seizures.
  • Pseudotumor Cerebri (Idiopathic Intracranial Hypertension): A condition characterized by increased pressure within the skull without any apparent cause, leading to headaches and vomiting, particularly in young, obese women.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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