Differential Diagnosis
- Single most likely diagnosis
- Tension headache: The headache was localized to one side of the head and resolved with trigger point therapy massage, which suggests a musculoskeletal origin. Tension headaches are common and often related to muscle tension, which can be exacerbated by trauma such as a slip and fall.
- Other Likely diagnoses
- Cervicogenic headache: Given the recent history of a slip and fall, it's possible that the headache is related to a cervical spine injury or strain, which can refer pain to the occipital region.
- Occipital neuralgia: The headache's location on the right side of the head and its resolution with trigger point therapy massage on the right occiput suggest possible irritation of the occipital nerve, which could be related to the recent trauma.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage or other intracranial hemorrhage: Although the headache resolved with massage, it's essential to consider the possibility of a more severe condition, especially given the recent trauma. A sudden, severe headache (often described as "the worst headache of my life") is a classic presentation of subarachnoid hemorrhage.
- Cervical artery dissection: This is a potentially life-threatening condition that can cause headache and is associated with trauma. It's crucial to consider this diagnosis, especially if there are other symptoms such as neck pain or neurological deficits.
- Rare diagnoses
- Temporomandibular joint (TMJ) disorder: Although less likely, TMJ disorders can cause referred pain to the head, including the occipital region. The recent trauma could have exacerbated a pre-existing condition.
- Glossopharyngeal neuralgia: This rare condition involves irritation of the glossopharyngeal nerve and can cause severe, sharp pain in the head, including the occipital region. However, it's typically associated with other symptoms such as throat pain or difficulty swallowing.