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Differential Diagnosis for Headache Pain Behind Eyes and at the Base of the Neck

Single Most Likely Diagnosis

  • Tension Headache: This is the most common type of headache and often presents with pain or discomfort in the back of the head and neck, as well as behind the eyes, typically due to muscle tension.

Other Likely Diagnoses

  • Migraine: Migraines can cause severe pain, often on one side of the head, but can also be bilateral and include pain behind the eyes and at the base of the neck. They are usually accompanied by other symptoms like nausea, vomiting, and sensitivity to light and sound.
  • Cervicogenic Headache: This type of headache originates from the cervical spine and can cause pain at the base of the neck and behind the eyes due to referred pain from the cervical nerves.
  • Sinusitis: Inflammation of the sinuses can cause pain behind the eyes and forehead, and sometimes this pain can radiate to the back of the head and neck.

Do Not Miss Diagnoses

  • Subarachnoid Hemorrhage: Although less common, a sudden, severe headache (often described as "the worst headache of my life") can be a sign of a subarachnoid hemorrhage, which is bleeding into the space surrounding the brain. This is a medical emergency.
  • Meningitis: Inflammation of the protective membranes covering the brain and spinal cord can cause severe headache, fever, and stiff neck. It requires immediate medical attention.
  • Temporal Arteritis: This condition involves inflammation of the blood vessels in the head and can cause severe headache, often accompanied by visual disturbances and jaw claudication. It's more common in older adults and can lead to blindness if not treated promptly.

Rare Diagnoses

  • Occipital Neuralgia: This involves irritation of the occipital nerves and can cause severe pain at the base of the skull, which can radiate to the eyes.
  • Chiari Malformation: A structural defect in the cerebellum that controls balance can cause headaches, often at the base of the skull, due to the pressure on the brain and spinal cord.
  • Trigeminal Neuralgia: Although it typically affects one side of the face, in rare cases, it can cause pain that might be perceived behind the eyes and could potentially radiate to the neck if other nerves are involved.

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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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