Differential Diagnosis for Sinus Headache
- Single Most Likely Diagnosis
- Migraine: This is often the most common cause of headaches that are mistaken for sinus headaches. Migraines can present with pain that is perceived as originating from the sinuses, especially if they involve the trigeminal nerve, which has branches that innervate the face and sinuses.
- Other Likely Diagnoses
- Tension Headache: These are common and can sometimes be confused with sinus headaches due to the location of the pain, which can be in the forehead, neck, and scalp.
- Sinusitis (Acute or Chronic): Inflammation or infection of the sinuses can cause pain that is typically localized to the area of the affected sinus, accompanied by other symptoms such as nasal congestion, discharge, and facial pressure.
- Cluster Headache: Although less common, cluster headaches can be mistaken for sinus headaches due to their severe, unilateral pain, often centered around the eye, and can be accompanied by nasal congestion or rhinorrhea on the same side.
- Do Not Miss Diagnoses
- Temporal Arteritis (Giant Cell Arteritis): This condition is crucial to diagnose promptly because it can lead to blindness if not treated. It typically presents with headache, scalp tenderness, jaw claudication, and visual disturbances in individuals over 50 years old.
- Cervicogenic Headache: Originating from the cervical spine, these headaches can refer pain to the face and be mistaken for sinus headaches. They are often associated with neck movement or trauma.
- Intracranial Hemorrhage or Mass: Although rare, any new or severe headache could potentially be a sign of a hemorrhagic stroke, aneurysm, or brain tumor, especially if accompanied by other neurological symptoms.
- Rare Diagnoses
- Trigeminal Neuralgia: Characterized by sudden, severe, shock-like pain around the eyes, lips, or nose, typically triggered by light touch, this condition can mimic sinus headache in its distribution of pain.
- Sphenoid Sinusitis: Due to its location, sphenoid sinusitis can cause deep, midline facial or headache pain and is often accompanied by other symptoms like fever and nasal discharge.
- Nasal or Sinus Tumors: Although rare, tumors in the nasal cavity or sinuses can cause facial pain or headache, often with other symptoms such as nasal obstruction, bleeding, or loss of smell.