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	+	-	-	+	-	-	-	-	-	-	-	-	+	-	-	episodic history of headaches	-	-	Clinical assesment
Seizure	-	+	+/-	-	+/-	-	+/-	+	+/-	+/-	-	-	-	-	+/-	Hx of seizure	prolactin levels, BMP	mass lesion +/-	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	<math>\uparrow</math>WBC low glucose
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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