Differential Diagnosis for Frontal Headache

• Single most likely diagnosis
  • Tension headache: This is the most common type of headache and often presents with a frontal or bilateral distribution, typically described as a band or a squeezing sensation around the forehead.
• Other Likely diagnoses
  • Migraine: Although migraines can occur in any part of the head, they often start on one side and can spread to the frontal area, accompanied by other symptoms like nausea, vomiting, and sensitivity to light and sound.
  • Sinusitis: Inflammation of the frontal sinuses can cause pain in the frontal area of the head, often accompanied by other symptoms such as nasal congestion, facial pain, and fever.
  • Cluster headache: These are severe headaches that occur in cycles or clusters, often waking the patient from sleep, and are typically centered around one eye but can radiate to the frontal area.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Subarachnoid hemorrhage: A life-threatening condition caused by bleeding into the space surrounding the brain, which can present with a sudden, severe headache, often described as "the worst headache" of the patient's life.
  • Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, which can cause headache, fever, neck stiffness, and confusion.
  • Temporal arteritis: Inflammation of the blood vessels in the head, which can cause headache, visual disturbances, and jaw claudication, particularly in older adults.
• Rare diagnoses
  • Trigeminal neuralgia: A chronic pain condition that affects the trigeminal nerve, which can cause intense, shock-like or stabbing pain in parts of the face, including the forehead.
  • Occipital neuralgia: Inflammation of the occipital nerves, which can cause pain in the back and top of the head, sometimes radiating to the frontal area.
  • Idiopathic intracranial hypertension: A condition characterized by increased pressure within the skull without any apparent cause, which can lead to headache, vision changes, and tinnitus.