Differential Diagnosis for Headache with Bending Head Down

• Single Most Likely Diagnosis
  • Tension headache: This is often the most common cause of headaches and can be exacerbated by bending down due to increased muscle strain in the neck and scalp.
• Other Likely Diagnoses
  • Sinusitis: Bending down can increase pressure in the sinuses, leading to pain, especially if there is an infection or inflammation.
  • Cervicogenic headache: These headaches are referred from the cervical spine and can be triggered or worsened by specific movements, including bending down.
  • Migraine: Some migraine sufferers may experience worsening of their headache with certain movements or positions, including bending down.
• Do Not Miss Diagnoses
  • Subarachnoid hemorrhage: Although less common, a sudden and severe headache that worsens with movement, including bending, could be indicative of a subarachnoid hemorrhage, which is a medical emergency.
  • Brain tumor: A headache that worsens with bending or straining could be a sign of increased intracranial pressure due to a tumor.
  • Idiopathic intracranial hypertension (IIH): This condition can cause headaches that worsen with maneuvers that increase intrathoracic pressure, such as bending down.
• Rare Diagnoses
  • Chiari malformation: This is a structural defect in the cerebellum that can cause headaches, especially with certain movements or positions, due to increased pressure on the brainstem.
  • Arteriovenous malformation (AVM): A rare condition where there is an abnormal connection between arteries and veins, which can cause headaches, including those that worsen with bending or straining.
  • Temporomandibular joint (TMJ) disorder: While more commonly associated with jaw pain, TMJ disorders can also cause headaches that might be exacerbated by certain movements, including bending down.