Differential Diagnosis for Posterior Headache that Wakes from Sleep and is Better with Movement
- Single Most Likely Diagnosis
- Tension headache: This is the most common type of headache and can occur at any time, including waking from sleep. Movement can sometimes alleviate tension, which might explain why the headache improves with activity.
- Other Likely Diagnoses
- Cervicogenic headache: These headaches are referred from the cervical spine and can be exacerbated by certain positions or movements, potentially waking a person from sleep. Improvement with movement could be due to changing the position of the cervical spine.
- Occipital neuralgia: This condition involves inflammation of the occipital nerves and can cause severe, sharp pains in the posterior part of the head. Movement might temporarily relieve pressure on the nerves, improving the pain.
- Do Not Miss Diagnoses
- Subarachnoid hemorrhage: Although less likely, a sudden, severe headache (often described as "the worst headache of my life") that wakes a person from sleep could be indicative of a subarachnoid hemorrhage. Improvement with movement would be atypical but cannot rule out this diagnosis without further investigation.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord can cause severe headache, fever, and stiff neck. While movement might not typically alleviate meningitis symptoms, it's crucial to consider this diagnosis due to its severity and potential for serious complications.
- Rare Diagnoses
- Chiari malformation: A structural defect in the cerebellum that controls balance can cause headaches, especially after lying down or with certain movements. While rare, it could potentially explain a headache that improves with movement.
- Hypnic headache: A rare condition characterized by recurrent headaches that wake patients from sleep, typically occurring on one side of the head but can be bilateral. They are often described as dull but can be severe and may improve with movement, although this is less characteristic.