Differential Diagnosis for Occipital Headache
- Single most likely diagnosis
- Tension headache: This is the most common type of headache and often presents with bilateral occipital pain, typically described as a band or a squeezing sensation around the head. The pain is usually mild to moderate and can be related to stress, poor posture, or muscle tension.
- Other Likely diagnoses
- Cervicogenic headache: This type of headache is referred from the cervical spine and can present with occipital pain, often unilateral, and is usually related to neck movement or posture. It can be caused by cervical spondylosis, herniated discs, or other cervical spine disorders.
- Occipital neuralgia: This condition involves irritation of the occipital nerves and can cause severe, sharp, or stabbing pain in the occipital region, often unilateral. It can be caused by trauma, compression, or inflammation of the nerves.
- Migraine: Although migraines typically present with unilateral pain, they can occasionally cause occipital headache. Migraines are often accompanied by other symptoms such as nausea, vomiting, photophobia, and phonophobia.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: Although rare, a subarachnoid hemorrhage can present with a sudden, severe occipital headache, often described as a "thunderclap" headache. This is a medical emergency that requires immediate attention.
- Meningitis: Inflammation of the meninges can cause severe headache, including occipital pain, accompanied by fever, stiff neck, and altered mental status.
- Cervical spine fracture or instability: Trauma to the cervical spine can cause occipital pain and requires immediate evaluation to prevent further injury or neurological compromise.
- Rare diagnoses
- Giant cell arteritis: This condition can cause headache, including occipital pain, and is often accompanied by jaw claudication, visual disturbances, and polymyalgia rheumatica.
- Temporomandibular joint disorder: Although more commonly associated with facial pain, temporomandibular joint disorder can occasionally cause referred pain to the occipital region.
- Chiari malformation: A congenital or acquired condition that can cause cerebellar tonsillar herniation, leading to occipital headache, often accompanied by neck pain, dizziness, and other neurological symptoms.