Differential Diagnosis for Posterior and Temporal Headache
Single Most Likely Diagnosis
- Tension Headache: This is the most common type of headache and often presents with a band-like pressure around the forehead, back of the neck, or both, which can include the posterior and temporal regions. The pain is usually mild to moderate, bilateral, and not accompanied by other symptoms.
Other Likely Diagnoses
- Migraine: While migraines are often unilateral and can affect any part of the head, they can sometimes be bilateral and involve the posterior and temporal areas. They are typically more severe than tension headaches and can be accompanied by nausea, vomiting, photophobia, and phonophobia.
- Cervicogenic Headache: Originating from the cervical spine, these headaches can refer pain to the posterior and temporal regions due to the convergence of cervical and trigeminal nerve pathways. They are often associated with neck movements or pressure on specific cervical areas.
- Temporal Arteritis: Although more common in older adults, temporal arteritis can cause headaches in the temporal region. It is characterized by a severe, unilateral headache, and jaw claudication is a classic symptom. However, it can sometimes present with posterior headache as well.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: A life-threatening condition that requires immediate medical attention. The headache is typically sudden, severe, and described as "the worst headache of my life." While it often presents as a thunderclap headache, it can sometimes be localized to the posterior or temporal region initially.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, which can cause severe headache, fever, and stiff neck. The headache can be generalized but may initially be perceived as posterior or temporal.
- Stroke or Transient Ischemic Attack (TIA): Headache can be a symptom of stroke or TIA, especially if it's a hemorrhagic stroke. The headache is often sudden and severe and can be accompanied by focal neurological deficits.
Rare Diagnoses
- Occipital Neuralgia: Involves the nerves that run from the base of the skull to the scalp and can cause severe, sharp, or stabbing pain in the posterior head or temporal region.
- Trigeminal Neuralgia: Although it typically affects the face, in rare cases, it can cause pain that is perceived in the temporal region due to the involvement of the trigeminal nerve.
- Chiari Malformation: A structural defect in the cerebellum that controls balance and can cause headaches, often in the posterior region, which can worsen with coughing, sneezing, or straining.