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Differential Diagnosis for Headache at the Back of the 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. It's usually bilateral and can be related to stress, poor posture, or muscle tension.

Other Likely Diagnoses

  • Cervicogenic Headache: Originates from the cervical spine and is often referred to the back of the head. It can be due to poor posture, neck strain, or cervical spine disorders.
  • Occipital Neuralgia: Involves the nerves that run from the neck up to the scalp, causing pain at the back of the head. It can be due to irritation or compression of these nerves.
  • Migraine: Although migraines are often unilateral, they can sometimes present with pain at the back of the head, especially if the migraine is in its early stages or if it's a variant like a basilar migraine.

Do Not Miss Diagnoses

  • Subarachnoid Hemorrhage: A life-threatening condition that requires immediate medical attention. Although it typically presents with a sudden, severe headache (often described as "the worst headache of my life"), the pain can sometimes 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. The headache can be generalized but may also be felt at the back of the head.
  • Cervical Artery Dissection: A tear in the wall of one of the arteries in the neck, which can lead to a stroke. It often presents with sudden, severe headache at the back of the head, along with neck pain.

Rare Diagnoses

  • Chiari Malformation: A structural defect in the cerebellum that controls balance, which can cause headaches, often at the back of the head, especially with coughing or straining.
  • Eagle Syndrome: A condition where the styloid process (a pointed piece of bone just below the ear) is elongated or the stylohyoid ligament is calcified, causing pain in the face and back of the head.
  • Giant Cell Arteritis: An inflammation of the arteries, which can cause headaches, often at the back of the head, along with visual disturbances and jaw claudication in older adults.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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