Headache differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sabeeh Islam, MBBS[2]


Disease History and Physical Examination PMHx Diagnostic approach
Unilateral Bilateral Throbbing character Autonomic symptoms Fever Photophobia Aphasia LOC Aura Nause/vomiting Rash Neck stiffness Vision changes Facial tenderness Neurologic deficits Labs and CSF findings CT/MRI Gold standard test
Migraine + - + - + - - + + - - + - - Trigger factors, family hx - - Clinical assesment
Tension-type headache (TTH) - + - - - - - - - - - - - - stress, genetics - - Clinical assesment
Cluster headache Clinical assesment
Seizure EEG
Meningitis - + + +/- +/- - - +/- +/- + - + Hx of fever, malaise <math>\uparrow</math>WBC

<math>\uparrow</math>Protein

<math>\downarrow</math>glucose

+/- CSF analysis
Encephalitis Hx of fever, malaise
Brain tumor
Subdural hemorrhage
Subarachnoid hemorrhage
Hypertensive encephalopathy
CNS abscess
Conversion disorder
Multiple sclerosis
Hemorrhagic stroke
Neurosyphilis
Wernicke’s encephalopathy Clinical assesment and lab findings
Drug toxicity
Metabolic disturbances
NPH
Sinusitis

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