Differential Diagnosis for Headache
- Single most likely diagnosis
- Postural headache (e.g., postural orthostatic tachycardia syndrome or orthostatic headache): The headache is worse with standing and improves with lying down, which suggests a postural component.
- Other Likely diagnoses
- Tension headache: The sharp pain on one side of the forehead could be consistent with a tension headache, although the postural component is not typical.
- Migraine: Although the headache is not severe (3/10) and lacks associated symptoms, some migraines can present with mild pain and without aura or other features.
- Sinus headache: The location of the pain on the right side of the forehead could suggest a sinus headache, but the lack of other symptoms such as nasal congestion or facial pressure makes this less likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: Although the headache is not severe and lacks sudden onset, any new headache with a postural component warrants consideration of a subarachnoid hemorrhage.
- Intracranial hypotension: This condition can cause a postural headache that worsens with standing and improves with lying down, and it is essential to consider it to avoid missing a potentially treatable cause.
- Cerebral venous sinus thrombosis: This rare condition can cause headache, and although it is unlikely, it is crucial to consider it due to its potential severity.
- Rare diagnoses
- Temporomandibular joint disorder: This condition can cause referred pain to the forehead, but it would typically be associated with jaw pain or clicking.
- Occipital neuralgia: This condition involves inflammation of the occipital nerve and can cause sharp pain on one side of the head, but it is relatively rare.
- Hypnic headache: This rare condition causes headache that occurs only when lying down and wakes the patient from sleep, which does not match the patient's symptoms.