Differential Diagnosis for Headache around the Front and Back of the Head
Single Most Likely Diagnosis
- Tension Headache: This is the most common type of headache and is often described as a band or a squeezing sensation around the forehead and back of the head, usually accompanied by muscle tension in the neck and scalp. The symptoms provided closely match the typical presentation of a tension headache.
Other Likely Diagnoses
- Migraine: Although migraines are often unilateral, some patients may experience bilateral pain, including around the front and back of the head. Migraines can also be associated with other symptoms like nausea, vomiting, and sensitivity to light and sound.
- Cervicogenic Headache: This type of headache is referred from the cervical spine and can present with pain around the back and front of the head due to the referral patterns of the cervical nerves. It is often associated with neck pain and stiffness.
- Sinusitis: Inflammation of the sinuses can cause pain in the front of the head, including the forehead and cheeks, and can sometimes radiate to the back of the head. Other symptoms may include nasal congestion, facial pressure, and fever.
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 a life-threatening condition requiring immediate medical attention. The pain can be diffuse, including the front and back of the head.
- Meningitis: Inflammation of the meninges can cause a severe headache that may be generalized, including the front and back of the head, along with fever, stiff neck, and altered mental status.
- Temporal Arteritis: This condition, more common in older adults, involves inflammation of the temporal arteries and can cause headaches on one or both sides of the head, including the front and back. It's a medical emergency due to the risk of vision loss if not promptly treated.
Rare Diagnoses
- Occipital Neuralgia: This condition involves irritation of the occipital nerves and can cause sharp, stabbing pain in the back of the head, which may occasionally radiate to the front. It's less common but should be considered in patients with specific patterns of pain and tenderness over the occipital nerve pathways.
- Chiari Malformation: A structural defect in the cerebellum that controls balance can cause headaches, often at the back of the head, which may worsen with coughing, sneezing, or straining. It's a rare condition that might be considered in patients with persistent, unexplained headaches and other neurological symptoms.