Differential Diagnosis for a 30-year-old Female with Severe Headache
- Single Most Likely Diagnosis
- Migraine: This is a common cause of severe headaches in young females, often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light or sound.
- Other Likely Diagnoses
- Tension Headache: Although typically less severe than migraines, tension headaches can be severe and are very common in the general population.
- Sinusitis: Infections or inflammation of the sinuses can cause severe headaches, often localized to the forehead or cheeks.
- Cluster Headache: These are extremely painful headaches that occur in clusters or cycles, but they are less common than migraines or tension headaches.
- Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: A life-threatening condition caused by bleeding into the space surrounding the brain, which can present with a sudden, severe headache (often described as "the worst headache of my life").
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, which can be caused by infection and presents with severe headache, fever, and stiff neck.
- Temporal Arteritis: Inflammation of the blood vessels in the head, which can cause severe headaches and is more common in older adults but should not be missed due to the risk of blindness if not treated promptly.
- Brain Tumor: Although rare, a brain tumor can cause severe headaches, especially if it increases intracranial pressure.
- Rare Diagnoses
- Idiopathic Intracranial Hypertension (IIH): A condition characterized by increased pressure within the skull without any apparent cause, which can lead to severe headaches.
- Trigeminal Neuralgia: A chronic pain condition that affects the trigeminal nerve, which can cause severe, shock-like pain in parts of the face.
- Hypnic Headache: A rare headache disorder that occurs only during sleep and wakes the patient up, typically in older adults but can occur at any age.