Differential Diagnosis for Sharp Stabbing Pain to Back of Head
Single Most Likely Diagnosis
- Tension Headache: This is the most common type of headache and can present with sharp, stabbing pain, especially in the absence of aura or specific triggers. The location at the back of the head is consistent with tension headaches, which often involve the posterior cervical and occipital regions.
Other Likely Diagnoses
- Cervicogenic Headache: Given the location of the pain at the back of the head, cervicogenic headache is a possibility. This type of headache is referred from the cervical spine and can be sharp and stabbing.
- Occipital Neuralgia: This condition involves inflammation of the occipital nerves and can cause sharp, stabbing, or electric shock-like pain in the back of the head. It might be considered if the pain is localized and severe.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although less likely given the description, a sudden, severe headache (often described as "the worst headache of my life") could be indicative of a subarachnoid hemorrhage. The absence of aura or triggers does not rule out this condition, and missing it could be fatal.
- Meningitis: Infection of the meninges can cause severe headache, often accompanied by fever, neck stiffness, and altered mental status. While the sharp, stabbing nature of the pain might not be typical, the potential severity of meningitis warrants consideration.
- Temporal Arteritis: This condition, more common in older adults but possible in younger individuals, involves inflammation of the temporal arteries and can cause severe, stabbing headaches. It's a "do not miss" diagnosis due to the risk of vision loss if not promptly treated.
Rare Diagnoses
- Chiari Malformation: A structural defect in the cerebellum that controls balance can cause headaches, often occipital, due to compression of the cerebellum and brainstem. These headaches can be sharp and stabbing.
- Trigeminal Neuralgia: Although more commonly associated with facial pain, in rare cases, the pain can radiate to the back of the head, presenting as sharp, stabbing pain.
- Arteriovenous Malformation (AVM): A rare condition where there's an abnormal connection between arteries and veins, potentially causing headaches due to the malformation pressing on brain tissue or due to hemorrhage. The headache can be sudden and severe.