Differential Diagnosis for Headache in a 7-Year-Old Female
Single Most Likely Diagnosis
- Tension Headache: This is the most common type of headache in children, often described as a mild to moderate, band-like pressure around the forehead, and can be related to stress, fatigue, or musculoskeletal strain.
Other Likely Diagnoses
- Migraine: Although less common than tension headaches, migraines can occur in children and are characterized by severe, unilateral headaches that may be accompanied by nausea, vomiting, and sensitivity to light and sound.
- Viral Infections: Common viral infections such as the flu or a cold can cause headaches in children due to fever, congestion, and overall body aches.
- Sinusitis: Inflammation of the sinuses can cause headaches, especially in the forehead and cheek areas, often accompanied by nasal congestion and discharge.
Do Not Miss Diagnoses
- Meningitis: An infection that inflames the meninges, the protective membranes surrounding the brain and spinal cord. Symptoms can include severe headache, fever, stiff neck, and vomiting. Early diagnosis and treatment are crucial.
- Brain Tumor: Although rare, brain tumors can cause headaches due to increased intracranial pressure. Other symptoms might include vomiting, vision changes, and neurological deficits.
- Subarachnoid Hemorrhage: Bleeding into the space between the brain and the tissue that covers it, which can cause a sudden, severe headache, often described as "the worst headache" ever experienced.
- Idiopathic Intracranial Hypertension (IIH): Also known as pseudotumor cerebri, this condition involves increased pressure within the skull without any apparent cause, leading to headaches, vision changes, and sometimes papilledema.
Rare Diagnoses
- Temporal Arteritis: An inflammation of the blood vessels in the head, more common in older adults but can rarely occur in children, causing severe headaches, jaw pain, and visual disturbances.
- Chiari Malformation: A structural defect in the cerebellum that controls balance, which can cause headaches, especially after coughing, sneezing, or straining, due to increased pressure on the brain and spinal cord.
- Pseudotumor Cerebri Syndrome: Similar to IIH but can be secondary to other conditions such as vitamin deficiencies or certain medications, leading to increased intracranial pressure and symptoms like headache and vision changes.