Summary
Differentials
Common
- Tension headache
- Migraine
- Acute sinusitis
- Otitis media
- Menstrual headache
- Medication withdrawal
- Medication overuse headache
- Cervical paraspinal muscle tenderness
- Dental caries/wisdom tooth impaction
- Temporomandibular disorders
- Acute hydrocephalus
Uncommon
- idiopathic intracranial hypertension (pseudotumor cerebri)
- Brain tumor
- Hypertensive encephalopathy
- Eclampsia/preeclampsia
- Pituitary apoplexy
- Venous sinus thrombosis
- Epidural hematoma
- Subarachnoid hemorrhage (SAH)
- Subdural hematoma
- Meningitis
- Brain abscess
- Carbon monoxide poisoning
- Concussive syndrome/trauma
- Acute mountain sickness/hypoxia
- Cluster headaches
- Paroxysmal hemicrania
- Trigeminal neuralgia
- Acute angle-closure glaucoma
- Giant cell arteritis
- Zika virus infection
- Chikungunya
- Dengue fever
- Stroke
Contributors
Authors
Meika T. Neblett, MD, MS
Associate Director
Department of Emergency Medicine
Saint Luke's Cornwall Hospital
Newburgh
NY
Disclosures
MTN declares that she has no competing interests.
Peer reviewers
Shuhan Zhu, MD
Member of the Faculty
Brigham Women's Hospital
Boston
MA
Disclosures
SZ declares that she has no competing interests.
Paul Hamilton, MD
Director
Department of Emergency Medicine
Mount Sinai School of Medicine
New York
NY
Disclosures
PH declares that he has no competing interests.
Sheldon Jacobson, MD, FACP, FACEP
Chairman
Department of Emergency Medicine
Mount Sinai School of Medicine
New York
NY
Disclosures
SJ declares that he has no competing interests.
Eirik Helseth, MD, PhD
Senior Neurosurgeon
Oslo University Hospital
Professor
University of Oslo
Oslo
Norway
Disclosures
EH declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
National Institute for Health and Care Excellence. Headaches in over 12s: diagnosis and management. Jun 2025 [internet publication].Full text
American College of Radiology. ACR appropriateness criteria®: headache. 2022 [internet publication].Full text Abstract
Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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