Tension Headache: Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Craniocervical transition anomaly – anatomic variant at the junction of the brain and spinal cord.

Respiratory system (J00-J99)

Eyes and eye appendages (H00-H59).

  • Glaucoma attack – eye disease with seizure-like elevated intraocular pressure.

Endocrine, nutritional and metabolic diseases (E00-E90).

Skin and subcutaneous (L00-L99)

Cardiovascular system (I00-I99).

  • Apoplexy (stroke)
  • Arteriovenous malformations (AVM) – congenital malformation of blood vessels in which the arteries are directly connected to the veins; these occur mainly in the CNS and facial cranium.
  • Chronic subdural hematoma (cSDH) – effusion of blood between the dura mater (outermost meninges) and the leptomeninges (soft meninges).
  • Hypertension (high blood pressure)
  • Sinus vein thrombosis (SVT) – occlusion of a cerebral sinus (large venous blood vessels of the brain arising from duraduplications) by a thrombus (blood clot); clinical presentation: headache, congestive papules, and epileptic seizures.

Musculoskeletal system and connective tissue (M00-M99).

  • Arteritis temporalis (synonyms: Arteriitis cranialis; Horton’s disease; giant cell arteritis; Horton-Magath-Brown syndrome) – systemic vasculitis (vascular inflammation) affecting the arteriae temporales (temporal arteries), especially in the elderly.
  • Myoarthropathy (MAP) of the masticatory muscles / painful disease of the masticatory muscles and / or temporomandibular joints, craniomandibular dysfunction (CMD).

Neoplasms – tumor diseases (C00-D48).

  • Brain tumors, unspecified
  • Nasal cavity tumors
  • Paranasal sinus tumors

Psyche – nervous system (F00-F99; G00-G99)

  • Chronic meningitis (meningitis).
  • Chronic migraineNote: If the headache is frequent or chronic, it must be differentiated from migraine.
  • Chronic paroxysmal hemicrania – Headache that has no symptom-free intervals.
  • Chronic hemiparesis headache
  • Encephalitis (inflammation of the brain)
  • Meningitis (meningitis)
  • Pseudotumor cerebri (idiopathic intracranial hypertension) – increase in pressure inside the skull (intracranial hypertension) without the presence of other causative space-occupying processes (i.e., tumors, hemorrhages, etc.).
  • Sleep apnea syndromesleep disorder with breathing pauses during sleep and daytime sleepiness.
  • SUNCT syndrome (shortlasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, sweating and rhinorrhea). – Headache with shorter attacks and higher frequency than cluster headache.
  • Trigeminal neuralgia – usually unexplained severe pain in the face due to irritation of a facial nerve.

Injuries, poisonings and other consequences of external causes (S00-T98).

  • Trauma (injury), unspecified

Other

  • Oromandibular dysfunction – mainly due to grinding of teeth at night.

Medication