UMEM Educational Pearls

Category: Neurology

Title: Unilateral Headaches

Keywords: headaches, cluster headache, migraine headache, glaucoma, temporal arteritis (PubMed Search)

Posted: 12/10/2009 by Aisha Liferidge, MD (Updated: 4/25/2024)
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The following is a differential diagnosis for unilateral headaches with typical associated features:

  • Migraine headache ->  throbbing pain preceded by aura; nausea; photophobia; chronicity.
  • Cluster headache ->  piercing eye pain; ipsilateral lacrimation and rhinorrhea; group of headaches come periodically in waves.
  • Temporal arteritis ->  dull ache over temporal artery; associated with arthralgia, myalgia, and anemia; typically in older populations.
  • Glaucoma ->  eye pain with cloudy appearing cornea; eyeball feels hard; pupillary dilitation may worsen pain.
  • Sinusitis ->  associated with sinus congestion; tenderness over sinus with or without swelling; typically only relieved with decongestants and/or antibiotics.
  • Subarachnoid hemorrhage ->  pain may be diffuse or unilateral; sudden onset of severe pain; may be associated with a stiff neck.