Tension headache: Difference between revisions
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==Background== | ==Background== | ||
===Definition<ref>International Headache Society Diagnostic Criteria</ref>=== | ===Definition<ref>International Headache Society Diagnostic Criteria</ref>=== | ||
#Headache lasting from 30 min to 7 d | #Headache lasting from 30 min to 7 d (but typically 4-6 hours) | ||
#Headache has at least two of the following characteristics: | #Headache has at least two of the following characteristics: | ||
#*Bilateral location | #*Bilateral location | ||
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#*No more than one of photophobia or phonophobia | #*No more than one of photophobia or phonophobia | ||
#Not attributed to another disorder | #Not attributed to another disorder | ||
#Classified as infrequent episodic (<1 day per month), frequent episodic (1-14 days per month) or chronic (>15 days per month) | |||
==Clinical Features== | ==Clinical Features== | ||
*Bilateral non-pulsating pain in a band-like or vice-like distribution around the head. | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Headache DDX}} | {{Headache DDX}} | ||
== | ==Evaluation== | ||
===Workup=== | |||
*Typically does not require tests/studies | |||
== | ===Diagnosis=== | ||
*NSAIDs | *Typically a clinical diagnosis | ||
*Consider treating severe tension | *After checking for all other causes of headache, palpate the temporalis, occipitalis and other muscles of the calvarium and neck to look for areas of tenderness and spasm that sometimes accompany tension headaches | ||
==Management== | |||
*[[NSAIDs]] | |||
*Consider treating severe tension headache like a migraine headache (can be difficult to distinguish) | |||
==Disposition== | ==Disposition== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
==Videos== | |||
{{#widget:YouTube|id=bWGi8KaFdso}} | |||
[[Category:Neurology]] | [[Category:Neurology]] | ||
Latest revision as of 14:02, 1 June 2022
Background
Definition[1]
- Headache lasting from 30 min to 7 d (but typically 4-6 hours)
- 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
- Classified as infrequent episodic (<1 day per month), frequent episodic (1-14 days per month) or chronic (>15 days per month)
Clinical Features
- Bilateral non-pulsating pain in a band-like or vice-like distribution around the head.
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
Workup
- Typically does not require tests/studies
Diagnosis
- Typically a clinical diagnosis
- After checking for all other causes of headache, palpate the temporalis, occipitalis and other muscles of the calvarium and neck to look for areas of tenderness and spasm that sometimes accompany tension headaches
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
Videos
{{#widget:YouTube|id=bWGi8KaFdso}}