Differential Diagnosis for Frontal Headache
- Single most likely diagnosis
- Tension headache: This is the most common type of headache and often presents with a bilateral, frontal, or occipital band-like pressure or tightness. The justification for this being the single most likely diagnosis is its high prevalence and the typical presentation of frontal headache.
- Other Likely diagnoses
- Migraine: Although migraines are often unilateral, they can sometimes be bilateral and may present with frontal headache. The presence of other migraine features such as nausea, vomiting, photophobia, or phonophobia would support this diagnosis.
- Sinusitis: Frontal headaches can be a symptom of sinusitis, especially if there is associated facial pain, nasal congestion, or purulent discharge.
- Cluster headache: These are severe, unilateral headaches that can occur in the frontal or temporal region, often accompanied by autonomic symptoms like lacrimation or nasal congestion.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: A sudden, severe headache (often described as "the worst headache of my life") can be a symptom of subarachnoid hemorrhage, which is a medical emergency.
- Meningitis: Headache, fever, and stiff neck are classic symptoms of meningitis, an infection of the meninges that requires prompt treatment.
- Temporal arteritis: This condition, also known as giant cell arteritis, can cause headaches, often in the temporal or frontal region, and is associated with visual symptoms and jaw claudication. It's a medical emergency due to the risk of blindness.
- Rare diagnoses
- Trigeminal neuralgia: This condition causes sudden, severe, shock-like pain in parts of the face, which can sometimes be interpreted as a frontal headache.
- Occipital neuralgia: Inflammation of the occipital nerves can cause pain that might radiate to the frontal region.
- Hypnic headache: A rare type of headache that occurs only during sleep and can wake the patient, often described as a dull, bilateral headache, including the frontal area.