Differential Diagnosis for Unilateral Headache with Runny Nose
- Single most likely diagnosis
- Cluster headache: This condition is characterized by severe, unilateral headaches often accompanied by autonomic symptoms such as nasal congestion or rhinorrhea (runny nose), lacrimation, and conjunctival injection on the same side as the headache.
- Other Likely diagnoses
- Migraine with autonomic features: Some migraines can present with unilateral headache and autonomic symptoms like nasal congestion or rhinorrhea, though these are less common than in cluster headaches.
- Sinusitis: Inflammation of the sinuses can cause unilateral headache and nasal discharge, especially if the infection is localized to one side.
- Trigeminal neuralgia: While primarily known for causing facial pain, some forms of trigeminal neuralgia can lead to autonomic symptoms including rhinorrhea, though headache is not the primary symptom.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Temporal arteritis (Giant Cell Arteritis): This condition can cause unilateral headache and, less commonly, nasal symptoms due to involvement of branches of the external carotid artery. It's crucial to diagnose early to prevent complications like vision loss.
- Cerebral venous sinus thrombosis: Though rare, this condition can present with headache and, in some cases, unilateral nasal symptoms if there's associated sinus involvement or infection. It requires prompt diagnosis and treatment to prevent severe outcomes.
- Rare diagnoses
- Raeder's syndrome (Paratrigeminal syndrome): A rare condition characterized by unilateral headache, ptosis, and ipsilateral autonomic dysfunction, which can include rhinorrhea.
- PHACE syndrome: A neurocutaneous syndrome that can include headaches and autonomic dysfunction, though it's more commonly associated with infantile hemangiomas and other congenital anomalies.
- Erythromelalgia: A disorder that can cause burning pain, heat, and redness in the hands and feet, and sometimes the face, potentially leading to unilateral headache and autonomic symptoms including rhinorrhea, though this is less common.