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 | ||
| Line 13: | Line 13: | ||
==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 | |||
==Management== | |||
*[[NSAIDs]] | |||
*Consider treating severe tension headache like a migraine headache (can be difficult to distinguish) | |||
==Disposition== | ==Disposition== | ||
| Line 31: | Line 37: | ||
==References== | ==References== | ||
<references/> | <references/> | ||
==Videos== | |||
{{#widget:YouTube|id=bWGi8KaFdso}} | |||
[[Category:Neurology]] | [[Category:Neurology]] | ||
Revision as of 21:31, 26 March 2019
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
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
- 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
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}}