Question

A young woman presents to the emergency room with a complaint of a band-like, bifrontal, squeezing headache that began 6 hours earlier. She denies nausea, vomiting, or any other associated symptoms. She describes the pain as waxing and waning in intensity throughout the 6-hour period. Physical examination is unremarkable. She reports suffering from similar attacks in the past. The most likely diagnosis is:

A. Tension-type headache
B. Migraine without aura
C. Migraine with aura
D. Paroxysmal hemicrania
E. Basilar migraine

Answer 1

The young woman's description of her headache is most consistent with a tension-type headache, characterized by a squeezing, band-like quality without additional migraine-associated symptoms such as nausea or visual disturbances.

Step-by-step explanation:

A young woman with a bifrontal, band-like, squeezing headache without nausea, vomiting, or other associated symptoms, and with unremarkable physical examination findings, is most likely experiencing a tension-type headache. This is supported by the description of her pain as waxing and waning, as well as her history of similar attacks. About 42% of all headaches worldwide are tension headaches, which can be triggered by factors such as stress and muscular tension.

Migraines without aura do not fit her symptom profile due to the absence of nausea and disturbed vision. Additionally, the fact that the headache is described as band-like and bifrontal does not typically suggest a migraine. Paroxysmal hemicrania and basilar migraine are also less likely due to the nature of the headache described and the lack of other accompanying symptoms that are typically observed with these conditions.