Differential Diagnosis for Partial and Occipital Pain
The patient presents with partial and occipital pain that is mild in severity but annoying, accompanied by a feeling of heaviness and an inability to press. The following differential diagnoses are considered:
- Single most likely diagnosis
- Tension headache: This is the most likely diagnosis given the description of mild, annoying pain with a feeling of heaviness, which are characteristic symptoms of tension headaches.
- Other Likely diagnoses
- Migraine: Although the pain is described as mild, some migraines can present with mild pain, especially if they are not fully developed or if the patient has a mild variant.
- Cervicogenic headache: The occipital location of the pain suggests possible referral from the cervical spine, making cervicogenic headache a plausible diagnosis.
- Temporomandibular joint (TMJ) disorder: TMJ disorders can cause pain in the face and head, including the occipital region, and might be considered given the feeling of pressure.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: Although the pain is mild, any new or sudden headache warrants consideration of a subarachnoid hemorrhage, which is a medical emergency.
- Meningitis: Infection of the meninges can cause headache, and while the symptoms might not fully align, meningitis is a condition that must be ruled out due to its severity.
- Giant cell arteritis: This condition can cause headache and is a medical emergency due to the risk of vision loss if not promptly treated.
- Rare diagnoses
- Occipital neuralgia: This condition involves inflammation of the occipital nerves and can cause severe pain, but it might present with milder symptoms in some cases.
- Chiari malformation: A structural defect in the cerebellum that can cause headache, among other symptoms, though it's less likely without other neurological signs.
- Idiopathic intracranial hypertension: Characterized by increased pressure within the skull without a detectable cause, which can lead to headache, among other symptoms.