Differential Diagnosis for Intense Neck Pain Radiating to Temples
Single Most Likely Diagnosis
- Tension Headache: This is the most likely diagnosis given the description of intense neck pain radiating to the temples without any history of injury. Tension headaches are common and often present with neck pain and headache that can radiate to the temples.
Other Likely Diagnoses
- Cervicogenic Headache: This type of headache is caused by referred pain from the cervical spine and can radiate to the temples. It is a common cause of neck pain and headache.
- Migraine: Although migraines can have an aura and are often unilateral, some patients may experience bilateral pain or pain that radiates from the neck to the temples.
- Temporal Arteritis: This condition, also known as giant cell arteritis, can cause severe headaches, but it typically affects older adults and may be accompanied by other symptoms such as jaw claudication and visual disturbances.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although less likely without a history of trauma, a sudden, severe headache (often described as "the worst headache of my life") could be indicative of a subarachnoid hemorrhage, which is a medical emergency.
- Meningitis: Infection of the meninges can cause severe headache, neck stiffness, and fever. It is crucial to consider this diagnosis, especially if the patient has other symptoms such as fever, confusion, or photophobia.
- Cervical Spine Fracture or Dislocation: Even without a history of injury, it's essential to consider the possibility of a cervical spine fracture or dislocation, especially if the patient has risk factors such as osteoporosis or a history of falls.
Rare Diagnoses
- Occipital Neuralgia: This condition involves inflammation of the occipital nerves and can cause severe pain in the neck and head that radiates to the temples.
- Atlantoaxial Subluxation: This rare condition involves instability of the joint between the first and second cervical vertebrae and can cause severe neck pain and headache.
- Eagle Syndrome: This condition is caused by an elongated styloid process or calcified stylohyoid ligament and can cause severe neck and facial pain, including pain radiating to the temples.