Dull headache without throbbing is one of the clinical features of tension-type headache. Dull pain: The pain is slow, persistent, and is a generalization of a variety of pains (e.g., distension, tight pressure pain, etc.), and is most often seen in headaches caused by chronic disorders, which are caused by insensitive pain-causing tissues. Tension-type headache is the most common type of headache and is generally considered to be more prevalent than migraine, accounting for about half of all outpatient headaches. What are the diseases that are easily confused with this disease? 1.Migraine is a vascular headache common in young and middle-aged people and children with pulsating throbbing pain in the temporal frontal orbit on one side, often accompanied by nausea and vomiting. The headache may be preceded by visual disturbances such as blurred vision, blind spot or hemianopia, or it may start without any aura, and the migraine usually lasts for several hours or days and is relieved. In a few patients, migraine may coexist with tension-type headache, making it difficult to distinguish between the two. 2. Cluster headache This kind of headache may be vascular and related to hypothalamic dysfunction. The headache is located on one side of the orbito-temporal frontal area and in severe cases, the headache is intensive and severe without aura. The headache attacks are rapid and can stop suddenly. The attacks are accompanied by conjunctival congestion, lacrimation and excessive sweating, and in some cases, ptosis. However, the remission period can last for months to years. It is not difficult to distinguish it from tension-type headache by detailed medical history and observation of attacks. 3.Trigeminal neuralgia It is an episodic transient severe pain in the distribution area of the trigeminal nerve of the face. The pain is only a few seconds each time, and it occurs several times to dozens of times a day. The pain is like cutting, burning or stabbing and is often triggered by washing, brushing, talking and chewing. Patients can often point out the location of the triggering pain, called the trigger point. The disease is more common in middle-aged and elderly people, and the 2nd and 3rd branches of the trigeminal nerve are more frequently involved. If the first branch is involved, it should be distinguished from ETTH. 4.Headache caused by intracranial occupational diseases These diseases include intracranial tumor, intracranial metastatic cancer, brain abscess and brain parasitic disease. These headaches are caused by increased intracranial pressure and are often accompanied by jet vomiting and fundus edema as the disease progresses, but they can be misdiagnosed as tension-type headache in the early stage. If pathological reflexes and other signs are found, it is often suggested that it is not tension-type headache and brain CT or MRI should be used in time to help differentiate. 5.Headache caused by chronic intracranial infection These diseases include tuberculous meningitis, fungal meningitis, porcine cysticercosis (cysticercosis) meningitis and syphilitic meningitis. However, in some atypical patients, the initial fever is low and the meningeal irritation sign is negative, which is easily misdiagnosed as tension-type headache. Therefore, when taking medical history, as long as there is a recent history of flu or suspicious pathological reflexes are found on physical examination, lumbar puncture should be considered in time for detailed testing of cerebrospinal fluid pressure, cytology, biochemical tryptophan and ink staining and other routine laboratory tests. If necessary, anti-tuberculosis antibodies in blood and cerebrospinal fluid, immunoassay for porcine cysticercosis (cysticercosis) and syphilis test should be tested simultaneously to help clarify the diagnosis. 6.Headache caused by autoimmune meningoencephalitis These diseases include neuroleukopenia, Vogt-Koyanagi-Harada syndrome and central nervous system nodular disease. These diseases can cause inflammatory reaction and headache when they involve the meninges or the main mass of the brain, and are not necessarily accompanied by fever, so they are easily misdiagnosed as tension-type headache. The exclusion of these diseases is based on a detailed history, a thorough physical examination and CT or MRI examination of the brain. The meningoencephalitis type of neuroleukopenia should have the basic signs of the disease such as mucosal ulcers of the mouth and eyes or external genitalia. vogt-koyanagi-harada syndrome is also known as uveal meningoencephalitis, so there should be eye damage, and those who have been ill for more than a few weeks often have clinical manifestations such as gray hair, alopecia, and white skin. central nervous system nodal disease often has focal signs in the brain and granulomatous damage on brain CT or MRI.