Differential Diagnosis for Tinnitus and Headache
Single Most Likely Diagnosis
- Tension Headache: This is the most common type of headache and can be associated with tinnitus due to muscle tension in the neck and scalp, which can affect blood flow and put pressure on nerves, including those involved in hearing.
Other Likely Diagnoses
- Migraine: Migraines can cause tinnitus, headache, and sensitivity to sound, among other symptoms. The headache can be severe and is often accompanied by nausea and vomiting.
- Benign Paroxysmal Positional Vertigo (BPPV): Although BPPV primarily causes vertigo, it can also lead to tinnitus and headache, especially if the vertigo episodes are severe or frequent.
- Anxiety or Stress: High levels of anxiety or stress can lead to both tinnitus and headache, as these conditions can increase muscle tension and affect the body's physiological response to stress.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although rare, a subarachnoid hemorrhage (bleeding into the space surrounding the brain) can present with a sudden, severe headache (often described as "the worst headache of my life") and potentially tinnitus if the bleed affects areas related to hearing or balance. This condition is medical emergency.
- Temporal Arteritis (Giant Cell Arteritis): This condition involves inflammation of the blood vessels and can cause headache and tinnitus, among other symptoms. It's more common in older adults and can lead to blindness if not treated promptly.
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which can cause tinnitus, hearing loss, and headache due to its location and potential to compress nearby structures.
Rare Diagnoses
- Meniere's Disease: A disorder of the inner ear that affects balance and hearing, leading to episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear. Headache can occur due to the vertigo or increased pressure in the ear.
- Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, potentially causing a wide range of symptoms including tinnitus and headache, depending on the areas of the central nervous system affected.
- Lyme Disease: Caused by a bacterial infection, Lyme disease can lead to neurological symptoms including headache and, less commonly, tinnitus, especially in later stages of the disease if left untreated.