Differential Diagnosis for Headache on Back of Head
- 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 back of the head, due to muscle tension.
- Other Likely diagnoses
- Cervicogenic headache: Refers to headaches caused by referred pain from the cervical spine, which can manifest as pain in the back of the head due to the convergence of cervical and trigeminal nerve pathways.
- Occipital neuralgia: Characterized by sharp, stabbing pain in the back of the head, often due to irritation or inflammation of the occipital nerves.
- Migraine: Although migraines typically present with unilateral pain, some individuals may experience pain that starts or is primarily located at the back of the head.
- 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 initially be localized to the back of the head.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, which can cause headache, fever, and stiff neck, with the headache sometimes being more pronounced in the back of the head.
- Cervical spine fracture or instability: Especially in the context of trauma, a fracture or instability in the cervical spine can cause severe pain in the back of the head and neck.
- Rare diagnoses
- Giant cell arteritis: An inflammatory condition affecting the blood vessels, which can cause headaches, often unilateral but sometimes bilateral, including pain in the back of the head, along with other symptoms like jaw claudication and visual disturbances.
- Chiari malformation: A structural defect in the cerebellum that controls balance, which can cause headaches, often worsened by coughing or straining, and may be perceived in the back of the head due to the anatomical location of the malformation.