Pain in the back of the head is observed with migraine, vertebrobasilar insufficiency, arterial hypertension, cerebral atherosclerosis, meningitis, encephalitis, occipital neuralgia, head and neck injuries, and some diseases of the muscles and spine. It can be dull, acute, local, diffuse, pressing, burning, pulsating. The cause of the symptom is established on the basis of complaints, examination data, additional instrumental and laboratory techniques. Treatment - analgesics, antibiotics, NSAIDs, antihypertensive, lipid-lowering drugs, neuroprotectors, physiotherapy, surgery.
With migraine, throbbing pain in the temple or forehead is more often observed, but in some patients the attack begins with painful sensations in the back of the head, which then spread to half of the head. Nausea, loss of appetite, photophobia, intolerance to loud sounds, an increase in the symptom against the background of any physical activity are characteristic. After the end of the episode, pallor, weakness, yawning are noted.
Basilar migraine is manifested by regular paroxysms that occur every few weeks or months. It is preceded by an extended aura lasting from 5 minutes to 1 hour, including tinnitus, dizziness, ataxia, double vision, dysarthria, and a number of other symptoms. After the aura, a sharp, usually one-sided pain in the back of the head appears, which in 30% of patients is combined with nausea, vomiting, sound and light phobia.
Headache with arterial hypertension is dull, pressing or arching, often localized in the back of the head. Complemented by dizziness, heaviness, pulsation, tinnitus. Lethargy, weakness, nausea, palpitations are noted. Along with primary hypertension, the manifestation is characteristic of symptomatic hypertension against the background of the following pathological processes:
With cerebral atherosclerosis, pain is detected at the initial stage, localized mainly in the back of the head or has a diffuse character. Appear during physical or emotional stress, combined with asthenia, sleep disturbances, memory impairment. Then cognitive and neurological disorders come to the fore.
Spondylogenic vertebrobasilar insufficiency is the result of compression of the vertebral arteries in trauma, degenerative diseases of the cervical vertebrae. Sharp soreness in the back of the head and neck on one side suddenly arises after an awkward movement, spreads to the temple, eyes and forehead. Complemented by falls, ataxia, pronounced vegetative reactions: pallor, marbling, sweating or dry skin.
With meningitis, pain in the back of the head is excruciating, bursting, radiating along the back of the neck. Appears against the background of intoxication syndrome. It is accompanied by an increase in muscle tone, a painful reaction to noise, light, and touch. Children may have seizures. The clinical picture of encephalitis depends on the type of disease. Typical signs are acute development with severe hyperthermia, cerebral symptoms. Sometimes convulsions, mental disorders, paresis, hyperkinesis are noted.
Neck pain
Pain in the back of the head or in the entire head accompanies craniocerebral injuries of any severity. The most common TBI is a concussion. Along with the pain syndrome, the victims complain of weakness, nausea. At the time of damage, loss of consciousness or a state of stunnedness is possible. With brain contusions, the clinical manifestations are more pronounced, the loss of consciousness is prolonged, meningeal symptoms are detected. Focal symptoms are possible.
Fracture of the cranial vault in the region of the occipital bone is manifested by a sharp sudden local pain. Then the pain spreads, supplemented by manifestations of TBI. In the area of damage, a hematoma is detected, sometimes an impression is palpated. In victims with wounds of the nape, the pain is less intense, from acute it turns into sore, accompanied by profuse bleeding.
Irradiation of pain in the back of the head can be observed with subluxations of the upper cervical vertebrae. The head is in a forced position, with attempts to move the pain syndrome intensifies. The muscles of the neck are tense. Sometimes there are dizziness, convulsions, goosebumps, weakness in the limbs.
Cervicalgia with a transition to the occipital region is found in cervical osteochondrosis. Pain is aggravated during movements, so patients keep their heads still, turn their whole body. The symptom is aggravated against the background of drafts, sleeping in an uncomfortable position. Over time, there are "lumbago" - sharp burning or throbbing pain. Paresthesia, muscle weakness are possible. With an intervertebral hernia, the manifestations are aggravated.
Drawing, shooting, burning pain in the neck and occiput, combined with sensory disturbances, limitation of movements, are noted in patients with spinal canal stenosis. With spondylitis against the background of infectious diseases and autoimmune pathologies, neck pain radiating to the back of the head is combined with signs of an inflammatory process.
It is provoked by injuries and diseases of the cervical vertebrae, hypothermia, muscle spasms, malformations, anomalies of the craniovertebral transition, some metabolic disorders, rheumatic diseases. Sometimes it develops spontaneously (Arnold's neuralgia). It is manifested by paroxysmal pain in the back of the head (more often - one-sided) radiating to the ears, neck. Extremely sharp, often painful, unbearable, reminiscent of an electric shock or intense pulsation.
The number of paroxysms in occipital neuralgia varies from one to several dozen per day, the duration of one episode varies from a few seconds to 1-2 minutes. Attacks develop after coughing, sneezing, sudden movements, or occur for no apparent reason. Between paroxysms, symptoms are often absent, sometimes dull aching pain, paresthesias persist.
Cervical myositis develops after hypothermia or overload. First, local cervicalgia appears. Then the pain spreads to the parietal and occipital regions, upper back. Increases with movement. Sometimes the cause of pain is myalgia. This condition is more often observed when an uncomfortable head position is maintained for a long time, including while working at a computer.
In victims of sunstroke, the headache is dull, pressing, often more pronounced in the occipital region. It is combined with dizziness, drowsiness, nausea, lethargy, hyperthermia. With heat stroke, pain in the back of the head is first aching, bursting, not intense. Gradually intensifies, becomes spilled. Complemented by nausea, increased heart rate and respiration, heaviness in the chest, pale skin, fever. Convulsions, psychomotor agitation, delirium, hallucinations are possible.
The symptom can be detected in the following diseases:
The nature of the pathology is determined by the neurologist. According to indications, an orthopedist-traumatologist, an infectious disease specialist, and other specialists are involved in the examination. The doctor finds out the time of occurrence, duration and nature of the pain syndrome, reveals other symptoms. When collecting an anamnesis, the doctor pays attention to possible provoking factors, the presence of chronic diseases.
Examination of the back of the head may indicate external changes (swelling, wounds, abrasions). Palpation is sometimes determined by tension, muscle compaction, enlarged lymph nodes. A neurological examination includes an assessment of reflexes, muscle strength, various types of sensitivity, and the detection of focal disorders. To clarify the diagnosis are assigned:
Neurologist examination
Emergency care is needed for sun and heat stroke. The victim is transferred to a shaded place, if possible, take off their clothes, apply cold (cool, but not ice compresses) to the forehead, chest, shins, hands. To prevent dehydration, give water or weak sweet tea. Patients with suspected head injury are provided with rest, laid on their side to prevent aspiration of vomit. In case of spinal injuries, the neck is immobilized with a cotton-gauze collar or improvised means (for example, a folded scarf).
The list of therapeutic measures is compiled taking into account the cause of the pain syndrome:
Patients with vascular pathologies undergo prosthetics of the brachiocephalic trunk, the creation of an extra-intracranial anastomosis, and carotid endarterectomy. Patients with vertebrobasilar insufficiency caused by diseases of the spine undergo laser vaporization of the intervertebral disc, microdiscectomy, resection of the cervical rib. Traumatic injuries may be an indication for PST of wounds, decompressive craniotomy, removal of depressed fractures, and hematoma evacuation.