Tension headache: Difference between revisions
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Revision as of 19:43, 30 July 2016
Background
Definition[1]
- Headache lasting from 30 min to 7 d
- Headache has at least two of the following characteristics:
- Bilateral location
- Pressure or tightening (nonpulsating quality)
- Mild or moderate intensity
- Not aggravated by routine physical activity such as walking
- Both of the following:
- No nausea or vomiting (anorexia may occur)
- No more than one of photophobia or phonophobia
- Not attributed to another disorder
Clinical Features
Differential Diagnosis
Headache
Common
Killers
- Meningitis/encephalitis
- Myocardial ischemia
- Retropharyngeal abscess
- Intracranial Hemorrhage (ICH)
- SAH / sentinel bleed
- Acute obstructive hydrocephalus
- Space occupying lesions
- CVA
- Carbon monoxide poisoning
- Basilar artery dissection
- Preeclampsia
- Cerebral venous thrombosis
- Hypertensive emergency
- Depression
Maimers
- Giant cell arteritis of temporal artery (temporal arteritis)
- Idiopathic intracranial hypertension (Pseudotumor Cerebri)
- Acute Glaucoma
- Acute sinusitis
- Cavernous sinus thrombosis or cerebral sinus thrombosis
- Carotid artery dissection
Others
- Mild traumatic brain injury
- Trigeminal neuralgia
- TMJ pain
- Post-lumbar puncture headache
- Dehydration
- Analgesia abuse
- Various ocular and dental problems
- Herpes zoster ophthalmicus
- Herpes zoster oticus
- Cryptococcosis
- Febrile headache (e.g. pyelonephritis, nonspecific viral infection)
- Ophthalmoplegic migraine
- Superior Vena Cava Syndrome
Aseptic Meningitis
- Viral
- Tuberculosis
- Lyme disease
- Syphilis
- Leptospirosis
- Fungal (AIDS, transplant, chemotherapy, chronic steroid use)
- Noninfectious
Evaluation
Management
- NSAIDs
- Consider treating severe tension headache like a migraine headache (can be difficult to distinguish)
Disposition
- Outpatient
See Also
References
- ↑ International Headache Society Diagnostic Criteria