Differential Diagnosis for Severe Headache with Neck Turning
- Single most likely diagnosis
- Cervicogenic headache: This condition is caused by referred pain from the cervical spine and is often triggered by specific movements or positions of the neck, making it a likely cause of severe headache with neck turning.
- Other Likely diagnoses
- Tension headache: Although not exclusively related to neck movement, tension headaches can be exacerbated by neck tension and turning, making it a plausible consideration.
- Migraine: Some migraine attacks can be triggered by neck movement or tension, and the severe headache associated with migraines could fit the description.
- Occipital neuralgia: Involves the nerves that run from the neck to the scalp and can cause severe headaches that are worsened by neck movement.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: Although less common, a sudden severe headache (often described as "the worst headache of my life") can be associated with neck stiffness and could potentially be triggered or worsened by neck movement.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, which can cause severe headache, neck stiffness, and fever.
- Cervical artery dissection: A tear in the wall of one of the arteries in the neck, which can lead to a stroke and may present with severe headache and neck pain, especially with movement.
- Rare diagnoses
- Temporomandibular joint (TMJ) disorder: Although more commonly associated with jaw pain, severe cases can radiate to the head and be exacerbated by movements that involve the neck.
- Eagle syndrome: A rare condition involving an elongated styloid process that can cause sharp, stabbing pain in the side of the throat and face, which might be worsened by neck turning.
- Atlantoaxial subluxation: A rare condition where the joint that connects the atlas (C1) and axis (C2) vertebrae becomes unstable, potentially causing severe headaches and neck pain, especially with movement.