Differential Diagnosis for Intermittent Constant Headaches
Single Most Likely Diagnosis
- Tension Headache: This is the most likely diagnosis due to the description of intermittent constant headaches all over the head, which is characteristic of tension headaches. The presence of stress also supports this diagnosis, as tension headaches are often triggered by stress.
Other Likely Diagnoses
- Migraine: Although the headache is described as being all over the head, some migraines can present with diffuse pain. The accompanying symptoms of nausea, lightheadedness, and shakiness are also common in migraines.
- Anxiety Disorder: The symptoms of stress, lightheadedness, shakiness, and nausea could also be indicative of an anxiety disorder, which can sometimes manifest with physical symptoms including headaches.
- Hypoglycemia: The symptoms of shakiness, lightheadedness, and nausea could suggest hypoglycemia, especially if the patient has a history of diabetes or is on medications that can cause low blood sugar.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although less likely, it's crucial to consider subarachnoid hemorrhage due to the potential severity and the fact that it can present with sudden, severe headache, nausea, and sometimes vague or nonspecific symptoms initially.
- Meningitis: Infection like meningitis can cause headache, nausea, and sometimes nonspecific symptoms like lightheadedness. It's a critical diagnosis not to miss due to its severe consequences if left untreated.
- Pituitary Apoplexy: A rare but potentially life-threatening condition that can cause sudden headache, nausea, and sometimes visual disturbances or altered mental status.
Rare Diagnoses
- Idiopathic Intracranial Hypertension (IIH): Characterized by increased intracranial pressure without a detectable cause, often presenting with headache and sometimes nausea. It's less common but should be considered, especially in patients with risk factors like obesity.
- Temporal Arteritis: An inflammatory condition affecting the blood vessels, particularly in older adults, which can cause headache, but it's less likely given the description of the headache being all over the head and the presence of other symptoms like shakiness.