Differential Diagnosis for 67-year-old Male with Left Sided Neck Pain Radiating to Posterior Left Side of Head
- Single Most Likely Diagnosis
- Cervicogenic headache: This condition is characterized by pain referred from the cervical spine to the head, often due to musculoskeletal issues or cervical spine degeneration. The radiation of pain from the neck to the posterior side of the head is consistent with this diagnosis, especially given the patient's age and the likelihood of cervical spine degeneration.
- Other Likely Diagnoses
- Tension headache: Although more common in younger populations, tension headaches can occur at any age and may present with neck pain radiating to the head.
- Cervical radiculopathy: This condition involves nerve root irritation or compression in the cervical spine, leading to pain that can radiate from the neck into the head, among other symptoms.
- Temporomandibular joint (TMJ) disorder: While TMJ disorders typically cause jaw pain, they can also lead to referred pain in the neck and head.
- Do Not Miss Diagnoses
- Subarachnoid hemorrhage or other intracranial hemorrhages: Although less likely, these conditions are medical emergencies that can present with sudden onset headache and neck pain.
- Cervical spine fracture or instability: Especially in older adults, trauma or osteoporosis can lead to cervical spine fractures, which require immediate medical attention.
- Giant cell arteritis: This condition can cause headache and neck pain, especially in older adults, and requires prompt diagnosis to prevent complications like vision loss.
- Rare Diagnoses
- Occipital neuralgia: Involves inflammation of the occipital nerves and can cause severe pain in the neck and back of the head.
- Neoplastic processes (e.g., metastases to the cervical spine or brain tumors): Although rare, these conditions can cause neck pain radiating to the head and must be considered, especially with a new onset of symptoms in an older adult.
- Inflammatory or infectious processes (e.g., cervical spine osteomyelitis or discitis): These conditions are less common but can cause significant morbidity if not promptly diagnosed and treated.