Differential Diagnosis for Headache with Vision Change
- Single Most Likely Diagnosis
- Migraine: This is a common condition that often presents with headaches accompanied by visual disturbances such as auras, photophobia, or blurred vision. The visual changes can precede, accompany, or follow the headache.
- Other Likely Diagnoses
- Tension Headache: While typically not associated with significant visual changes, some patients may experience blurred vision or sensitivity to light.
- Cluster Headache: These are severe headaches that can be accompanied by autonomic symptoms, including ocular symptoms like ptosis or miosis, and may rarely include visual disturbances.
- Sinusitis: Inflammation of the sinuses can cause headaches and, due to the proximity of the sinuses to the eyes, may lead to facial pain and pressure that could be perceived as affecting vision.
- Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: A life-threatening condition where bleeding occurs in the space surrounding the brain, often presenting with a sudden, severe headache (thunderclap headache) and potentially accompanied by visual disturbances due to increased intracranial pressure.
- Pituitary Apoplexy: A medical emergency where a pituitary tumor suddenly hemorrhages or infarcts, leading to severe headache, visual field defects, and potentially blindness if not promptly treated.
- Temporal Arteritis (Giant Cell Arteritis): An inflammatory condition affecting the medium and large arteries, which can lead to headaches, visual disturbances (including blindness), and jaw claudication. Prompt diagnosis and treatment are crucial to prevent permanent vision loss.
- Stroke: Although less common, certain types of stroke can present with headache and visual changes, especially if the visual pathways or the eye itself are involved.
- Rare Diagnoses
- Idiopathic Intracranial Hypertension (IIH): A condition characterized by increased pressure within the skull without a detectable cause, often presenting with headache and visual disturbances, including papilledema.
- Occipital Lobe Seizures: Seizures originating from the occipital lobe can cause visual auras or hallucinations, sometimes accompanied by headache.
- Cavernous Sinus Thrombosis: A rare but serious condition involving a blood clot in the cavernous sinus, which can lead to headache, visual disturbances, and cranial nerve deficits.