Differential Diagnosis for a 12-year-old with Headache
- Single most likely diagnosis:
- Tension headache: This is the most common type of headache in children and adolescents, often related to stress, poor posture, or muscle tension.
- Other Likely diagnoses:
- Migraine: A common cause of headache in children, characterized by recurrent episodes of severe headache, often accompanied by nausea, vomiting, and sensitivity to light and sound.
- Sinusitis: Inflammation of the sinuses can cause headache, facial pain, and nasal congestion, especially if the child has a history of allergies or recent upper respiratory infection.
- Viral illness: Many viral illnesses, such as the common cold or flu, can cause headache in children.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Meningitis: A life-threatening infection that causes inflammation of the meninges, characterized by severe headache, fever, stiff neck, and vomiting.
- Subarachnoid hemorrhage: Bleeding into the space surrounding the brain, which can cause sudden, severe headache, often described as "the worst headache of my life."
- Brain tumor: Although rare, brain tumors can cause headache, especially if they increase intracranial pressure or obstruct the flow of cerebrospinal fluid.
- Idiopathic intracranial hypertension (IIH): A condition characterized by increased pressure within the skull, causing headache, vision changes, and papilledema.
- Rare diagnoses:
- Temporal arteritis: Inflammation of the blood vessels in the temples, which can cause headache, jaw pain, and visual disturbances, although it is more common in older adults.
- Pseudotumor cerebri: A condition similar to IIH, but without a clear cause, characterized by increased intracranial pressure and headache.
- Arteriovenous malformation (AVM): A rare congenital condition where blood vessels in the brain are abnormal, which can cause headache, seizures, or bleeding.