Differential Diagnosis
- Single most likely diagnosis
- Tension headache: This is the most likely diagnosis given the patient's history of teeth grinding, which can lead to tension headaches. The headache is constant, not debilitating, and changes location, which is consistent with tension headaches. The temporary relief with Advil also supports this diagnosis.
- Other Likely diagnoses
- Migraine: The patient had an episode of severe, migraine-like headache with nausea and vomiting, which suggests that migraines could be a contributing factor to their headaches.
- Sinus headache: Although the patient denies sinus pressure, the history of nasal surgery and deviated septum could contribute to sinus headaches.
- Medication overuse headache: The patient uses Advil for temporary relief, which could potentially lead to medication overuse headaches, although there is no indication of excessive use.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: Although the patient denies severe headache onset, neck stiffness, and other red flags, it is essential to consider this diagnosis due to its high mortality rate.
- Brain tumor: The patient's persistent and constant headache, although not debilitating, warrants consideration of a brain tumor, especially given the absence of other clear explanations.
- Temporal arteritis: This condition can cause headaches, fatigue, and lightheadedness, and is a medical emergency due to the risk of vision loss.
- Rare diagnoses
- Occipital neuralgia: This condition can cause headaches, often described as sharp or stabbing, and could be considered given the patient's description of a "floating sensation" when walking.
- Hypnic headache: This rare condition causes headaches that occur only during sleep, which could be considered given the patient's report of headaches present upon waking and sleeping.
- Cervicogenic headache: This type of headache is caused by referred pain from the cervical spine, which could be considered given the patient's history of teeth grinding and potential cervical spine strain.