Differential Diagnosis of Headache

1. HEADACHE
DUR-E-NABI
ROLL NO: 66

2. HEADACHE
The Brain itself doesn’t feel any pain, why?
-Because it has no pain receptors.
-Injury to the brain doesn’t cause any pain, it
alters brain function.

3. Pain in the head, known as headache, is related
to pressure on other sensitive structures, such
as:
• Blood vessels
• Cranial nerves
• Sinuses
• Meninges

4. • Following are the types of headache:
1. Primary Headache : Includes:
• Migraine
• Cluster
• Tension-type headache.
2. Secondary Headache: Includes causative
disorders like:
• Cervicogenic headache
• Cranial Neuralgia

5. Primary Headache
• Cluster headache is very rare.
• Migraine is the most common headache for
which patient seeks medical attention.
• Tension type headache is usually managed
with OTC drugs and not brought up at clinic
visits.

6. Primary Headache Types

7. MIGRAINE
• Frequency 1-2/year- 2-3/week
• Pain Moderate - severe
pulsating, throbbing
• Duration 4 hrs. - 3 days
• Location Usually one sided
• Symptoms Aura, nausea, vomiting,
Sensitive to light, smell,
perfume etc.
• Signs Facial pallor, cold limbs

9. CERVICOGENIC HEADACHE
Cervicogenic headache is defined as referred
pain in any part of the head caused by
musculoskeletal tissue innervated by cervical
nerves. It can be due to:
-chronic tension
-Whiplash injury
-Intervertebral disc disease
-Progressive facet joint arthritis

10. CAUSES OF HEADACHE
• Hypertension
• Cerebral Venous Thrombosis
• Impending stroke
• Temporal vasculitis
• Stress and inadequate coping
• Excessive caffeine consumption
• Post traumatic brain-injury
• Post whiplash injury
• Post concussion injury

11. Headache and Brain Tumor?
-Rarely there is headache causing brain tumor.
-Risk factors include:
• Exposure to gases and chemicals
• History of chemotherapy for fungal scalps
-Primary head & neck cancers can cause headaches.
-Rapidly growing tumors are more associated with
headaches.
-Headaches associated with brain tumors are usually
bioccipital or bifrontal, intermittent and of increasing
duration.
-Tension type or migraine can occur with tumors.

12. • Aspirin, acetaminophen or other pain killers
can relieve the pain.
• Vomiting with tumors occur in 25-30% of
people.
• Pain with history of CGH is red flag.
• Migraine in childhood is yellow flag.
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