Differential Diagnosis
- Single most likely diagnosis
- Occipital Neuralgia: This condition is characterized by sharp, stabbing pain on one side of the neck that radiates to the scalp, matching the patient's symptoms. The pain is often intermittent and brief, lasting only seconds.
- Other Likely diagnoses
- Cervicogenic Headache: Although the patient denies headache, some forms of cervicogenic headache can present with neck pain radiating to the scalp without typical headache features.
- Temporomandibular Joint (TMJ) Disorder: TMJ disorders can cause radiating pain to the neck and scalp, although the pain is usually more constant and associated with jaw movements.
- Tension Neck Syndrome: This condition involves muscle tension in the neck, leading to pain that can radiate to the scalp, but it's typically more constant and associated with stress or poor posture.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid Hemorrhage: Although the patient denies headache or vision changes, a "thunderclap" headache can sometimes be preceded by brief, sharp pains. It's crucial to consider this diagnosis due to its high mortality rate if missed.
- Cervical Artery Dissection: This condition can cause sudden, severe neck pain that may radiate to the scalp, and it's essential to diagnose promptly to prevent stroke.
- Meningitis: In rare cases, meningitis can present with severe, stabbing headaches or neck pain without typical symptoms like fever or stiff neck, especially in early stages.
- Rare diagnoses
- Glossopharyngeal Neuralgia: This condition involves sharp, stabbing pain in the throat, ear, or tongue, but it can occasionally radiate to the neck or scalp.
- Eagle Syndrome: This rare condition involves an elongated styloid process causing sharp pain in the neck, ear, or side of the face, which can radiate to the scalp.
- Neoplastic or Infectious Processes: Rarely, tumors or infections in the neck or scalp can cause sharp, intermittent pain, although these would typically be associated with other symptoms like masses, fever, or weight loss.