Differential Diagnosis for Posterior Headaches
- Single most likely diagnosis
- Tension headache: This is the most common type of headache and often presents with a band-like pressure or tightness around the head, including the posterior region, typically due to muscle tension.
- Other Likely diagnoses
- Cervicogenic headache: Refers to headaches caused by referred pain from the cervical spine, often involving the posterior aspect of the head, and is usually associated with neck movement or trauma.
- Occipital neuralgia: Characterized by sharp, stabbing pain in the posterior head, often due to irritation or inflammation of the occipital nerves.
- Migraine: Although migraines can present with unilateral pain, they can sometimes involve the posterior aspect of the head and are accompanied by other symptoms like nausea, vomiting, and sensitivity to light and sound.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: A life-threatening condition that can present with a sudden, severe headache, often described as "the worst headache of my life," which may involve the posterior aspect of the head.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, which can cause severe headache, including posterior headache, along with fever, stiff neck, and altered mental status.
- Cervical artery dissection: A tear in the wall of one of the arteries in the neck, which can lead to stroke and may present with posterior headache and neck pain.
- Rare diagnoses
- Temporomandibular joint (TMJ) disorder: Although more commonly associated with jaw pain, TMJ disorders can radiate pain to the posterior head.
- Eagle syndrome: A rare condition characterized by an elongated styloid process or calcified stylohyoid ligament, which can cause sharp, stabbing pain in the posterior head and face.
- Chiari malformation: A structural defect in the cerebellum that can cause posterior headache, especially with coughing or straining, due to herniation of the cerebellar tonsils into the spinal canal.