Differential Diagnosis for 28-year-old Female with Headache and Neck Stiffness
Single Most Likely Diagnosis
- Cervicogenic Headache: This is the most likely diagnosis given the patient's history of a car accident, which can cause neck injury leading to referred pain to the head. The pain's location on the crown and back of the head, radiating from the neck, supports this diagnosis. Cervicogenic headaches are common after whiplash injuries from car accidents.
Other Likely Diagnoses
- Tension Headache: Given the patient's description of the pain and its relatively mild intensity, tension headache is a plausible diagnosis. Tension headaches can be exacerbated by stress and physical strain, such as that from a car accident.
- Muscle Strain: The accident could have caused muscle strain in the neck and scalp, leading to headache. This is a common and straightforward diagnosis given the context.
- Post-Traumatic Headache: This is a broad category that can include various types of headaches occurring after a traumatic event like a car accident. The patient's symptoms could fit within this category, especially considering the recent trauma.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although less likely given the mild pain level and absence of severe symptoms like sudden severe headache, vomiting, or loss of consciousness, subarachnoid hemorrhage is a critical diagnosis that must be considered, especially in the context of trauma. Missing this diagnosis could be fatal.
- Meningitis: While the patient does not display classic symptoms of meningitis (e.g., fever, severe headache, stiff neck, and altered mental status), the presence of neck stiffness warrants consideration of this potentially life-threatening condition.
- Cervical Fracture or Dislocation: The patient's history of a car accident puts her at risk for cervical spine injuries, which could present with neck stiffness and headache. This is a critical diagnosis to consider to prevent further injury.
Rare Diagnoses
- Temporal Arteritis: Although rare in a 28-year-old, temporal arteritis could present with headache. However, it typically affects older adults and is associated with other symptoms like jaw claudication and visual disturbances.
- Occipital Neuralgia: This condition involves inflammation of the occipital nerves and can cause headache, but it is less common and might not directly relate to the car accident unless there was specific trauma to the area.