Tension-Type Headache Mimics

Crystal, Sara C.; Robbins, Matthew S.

doi:10.1007/s11916-011-0226-y

Cited by 13 publications

(6 citation statements)

References 41 publications

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“…It has been noted that tension-type headache can present itself as GCA. [11] However, our case presents an opposite dilemma, as our patient presented with atypical features of GCA that were more characteristic of tension-type headache. That is, GCA presented itself as tension-type headache.…”

Section: Discussionmentioning

confidence: 70%

Giant cell arteritis or tension-type headache?: A differential diagnostic dilemma

Rana

Saeed

Khan³

et al. 2014

Journal of Neurosciences in Rural Practice

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Giant cell arteritis (GCA) or Temporal arteritis (TA) is an autoimmune disease and the most common type of vasculitis in the elderly. It causes inflammation of the medium and large arteries in the upper part of the body. GCA is an under-recognized cause of head aches in the elderly, especially when it presents itself with atypical features, resulting in delayed or incorrect diagnosis. Since GCA is a treatable condition, an accurate diagnosis is crucial to prevent the most serious complication of CGA, permanent vision loss. The diagnosis can be further complicated as GCA may present with features of other painful neurological conditions. The present case is an 81-year-old woman diagnosed with GCA, who initially presented with features similar to tension-type headache. Due to overlapping features of these conditions, the diagnosis of GCA was delayed, resulting in irreversible vision loss. Although previous research highlights diagnostic dilemmas featuring GCA and other disease states, this case is exclusive in describing a unique dilemma where tension-type headache mimics GCA.

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Section: Discussionmentioning

confidence: 70%

Giant cell arteritis or tension-type headache?: A differential diagnostic dilemma

Rana

Saeed

Khan³

et al. 2014

Journal of Neurosciences in Rural Practice

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“…The typical TTH phenotype is probably the most unspecific, and many conditions might have similar features, such as migraine, hemicrania continua, primary cough headache, primary exercise headache, primary headache associated with sexual activity, external-pressure headache, hypnic headache, new daily persistent headache and the vast majority of secondary headache disorders 6,8 . Misdiagnosis might be related to the classification of patients based on pain phenotype; however, headache diagnosis should be performed by integrating prior medical history, headache anamnesis, presence of other symptoms and neurological examination, not solely by headache phenotype 8,21 .…”

Section: Discussionmentioning

confidence: 99%

“…Given the mild nature of the disorder, few patients seek assistance, and in headache unit-based series, it is not a frequent diagnosis, accounting for 16% of all diagnoses 7 . On the other hand, it is not uncommon for migraine patients to be erroneously diagnosed with TTH 8 .…”

mentioning

confidence: 99%

Tension-type headache in the Emergency Department Diagnosis and misdiagnosis: The TEDDi study

García‐Azorín

Farid-Zahran

Gutiérrez‐Sánchez

et al. 2020

Sci Rep

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Headache is a common reason to visit the emergency department (eD). tension-type headache (ttH) is the commonest headache. the diagnosis of ttH implies a mild condition, with no need for special tests. We evaluated the use of the International Classification of Headache Disorders (ICHD) criteria for TTH in the ED. We performed a cross-sectional study including all ED patients with a definite TTH diagnosis in their discharge report for 2.5 years. We evaluated whether the ICHD criteria for TTH were referenced and met. We analysed discrepancies concerning anamnesis or prior history and reclassified patients. A total of 211 out of 2132 patients fulfilled the criteria (9.9%). Only five patients fulfilled TTH criteria. Criteria A-D were referenced in 60-84% of patients and met in 16-74% of these patients. Anamnesis was discrepant in 87.5% as was prior history in 20.8%. After re-reclassification, 21 patients fulfilled the criteria for TTH (five) or probable TTH (16). In 106 patients, another headache was diagnosed, with migraine in 40 (18.9%), secondary headache in 64 (30.3%), and a life-threatening disorder in 13 (6.1%). In our sample, TTH was overdiagnosed. Only a minority of patients fulfilled the ICHD criteria. inconsistencies in prior medical history or anamnesis were frequent. This is an observational study with a cross-sectional design. Our study population included patients who visited the emergency department due to headache. The study was performed according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines 17 .The study took place at the ED of the Clínico San Carlos University Hospital, Madrid (Spain), a third-level hospital with a reference population of 700.000 people. The study period was between Eligibility. The inclusion criteria were as follows: 1) patients visiting the ED because of headache and 2) patients with a definite diagnosis of "tension-type headache" in the ED discharge report. We excluded patients with 1) some degree of uncertainty in the diagnosis, such as "possible" or "probable"; 2) another headache diagnosed at the same time; and 3) no available information in the patient chart.We screened all the patients who visited the ED during the study period because of headache by using the ED database, which codifies patients by initial reason for consultation. We reviewed the digitalized reports and gathered the information from the discharge reports. We did not review any additional sources, and we did not evaluate any patients. The rationale for this was that we aimed to see if with the information present in the ED reports, TTH diagnosis was appropriate or not.The included demographic variables were sex; age; and relevant prior medical history, including current or past cancer, pathology of the immune system, and prior headache history. Clinical variables included headache description, with special attention to the presence of any red flag, neurological examination and abnormal focal signs, vital signs and general examination. Scientific RepoRtS |(...

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“…1 The deliberate exercise of localization may help facilitate the consideration of otherwise overlooked secondary causes, which have been previously reviewed in prior work. 2 This approach would reflect a more refined process-informed by knowledge of both neuroanatomic and head and neck localizations-than is otherwise captured by the traditional guidance of red flag assessment alone. In this regard, the process challenges the diagnostician to not fall victim to heuristic pitfalls, such as confirmatory bias, where the history is only used to support an initial impression and not to test alternative hypotheses.…”

Section: How C An Cons Idering Loc Aliz Ation Impac T Patient C Are I...mentioning

confidence: 99%

Localization in headache medicine: A systematic approach to diagnosis

Smith

Robbins

2023

Headache

Self Cite

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Tension-Type Headache Mimics

Cited by 13 publications

References 41 publications

Giant cell arteritis or tension-type headache?: A differential diagnostic dilemma

Giant cell arteritis or tension-type headache?: A differential diagnostic dilemma

Tension-type headache in the Emergency Department Diagnosis and misdiagnosis: The TEDDi study

Localization in headache medicine: A systematic approach to diagnosis

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