Differential Diagnosis for Frontal Headache

The following is a differential diagnosis for frontal headache, categorized for clarity and emphasis on potential severity.

• Single Most Likely Diagnosis
  • Tension headache: This is the most common type of headache and often presents with a bilateral, band-like pressure around the forehead, which can be attributed to muscle tension, stress, or poor posture.
• Other Likely Diagnoses
  • Migraine: Although migraines can occur in any part of the head, they often involve the frontal area and can be accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound.
  • Sinusitis: Inflammation or infection of the frontal sinuses can cause pain in the forehead area, often accompanied by nasal congestion, facial pressure, and purulent discharge.
  • 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 Diagnoses
  • 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 my life") and may involve the frontal area.
  • 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 temples, 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, usually triggered by light touch.
  • Occipital neuralgia: Inflammation of the occipital nerves, which can cause pain in the back and top of the head, but sometimes radiates to the frontal area.
  • Idiopathic intracranial hypertension (IIH): A condition characterized by increased pressure within the skull without any apparent cause, leading to headache, vision changes, and sometimes papilledema.

Each of these diagnoses has distinct characteristics and accompanying symptoms that can help guide a more precise diagnosis and appropriate treatment plan.