The Differential Diagnosis For Chronic Headache

Headache is the most common physical complaint and can be bothering if occurs every day.

Though very few chances, sometimes headache can be life-threatening, therefore it becomes important to appropriately treat the patients.

Headache can be primary or secondary.

Primary Headache: These headaches occur unto themselves rather than being a sign of any other illness. These can be potentially disabling but are rarely life-threatening.

Tension headache, migraine headaches, and cluster headaches are examples of primary headache.

Secondary Headaches: This type of headache occurs as a symptom of other illnesses. Secondary headaches can be potentially dangerous. Secondary headache can occur due to degenerative joint disease, temporomandibular joint syndrome, due to respiratory tract illness and others.

Differential Diagnosis Of Chronic Headache

Tension Headache

Tension headache is diffuse mild to moderate pain in the head. There is a feeling of a tight band around the head. There is also tenderness in the scalp, neck, and shoulder muscles in this headache.

Migraine Headache

Migraine is a powerful headache, accompanied by nausea, vomiting, and sensitivity to light.

It is estimated that more than 36 million Americans are affected by migraine(1)

This headache can last up to several hours and even days. It is aggravated by allergies, light, and stress.

Cluster Headache

Cluster headache is a primary headache that can occur several times a day. This headache is not common and is found affecting 1 in every thousand people(2)

An individual tends to get it at the same time every year and is often mistaken for allergy or business stress.

The pain is on the same side of the head and can include red or teary eye, stuffy or runny nostrils and flushing of the face.

Cervicogenic Headaches

The cervical degenerative joint disease occurs when the disc starts to degenerate and press the spinal column. These are known as cervicogenic headaches.

It is a secondary headache which is characterized by significant neck pain as well as headache.

Headache Due To Overuse Of Medication

If a person taking certain medications such as hydrocodone, analgesic, ergotamine, to stop the headache and discontinues them all together, the headache can occur again and can be even more severe.

Withdrawal from caffeine can also result in a continuous headache until a product with caffeine is consumed.

These headaches are also known as rebound headaches.

Sinus headache

A sinus headache can occur when the air-filled sinus cavities in the face cause pressure and pain.

It is often confused with migraine headaches.

This type of headache can occur due to allergies or when the sinuses get triggered due to any of the reasons.

The pain gets worse on leaning forward and there is an uncomfortable pressure behind the forehead.

Thunderclap Headaches

These are the abrupt, severe headaches which come quickly. They come up suddenly without warning and last for up to five minutes.

These headaches can signal an underlying health condition such as problems in the blood vessel in the brain and would require prompt medical attention.

Headache can be a symptom of a disease or any other medical condition. The doctor decides the cause by taking a medical history and physical examination.

The doctor may also run a diagnostic test, which includes:

Most of the headache symptoms are not due to any life-threatening illness. If the symptoms are accompanied by drowsiness, fever, vomiting, slurred speech, convulsion, or weakness in an arm or leg, it can be a reason to give a thought.

The treatment of headaches varies according to the condition diagnosed. There are various natural ways as well which can help manage the symptoms. A healthy lifestyle and plenty of sleep can help in preventing headaches. Good health practices are good headache prevention techniques.

Consult a doctor in the following situation:

  • A severe headache occurs two or more times a week
  • The headache worsens with time and also despite taking rest and medication
  • The headache is disabling
  • The pattern of headache changes
  • The headache accompanies with fever, neck stiffness, seizure, double vision, or difficulty in speaking.

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