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Pain in head/ skull
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Pain in head/ skull

Hi,

I've been experiencing an annoying type of pain in the back/ top of my head for nearly a month now. It comes randomly, and it's not a sharp pain. If I'm busy (and not thinking of my health, as I tend to do 90% of the day:( then I don't usually experience it.

Is there reason for worry? I had blood work done not long ago and everything came back fine. I am an anxiety sufferer and have been depressed lately, partly due to these weird feelings I have been experiencing.

Please help!!
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Headaches can be a primary headache (such as a migraine) or secondary headache (such as from a structural lesion in the brain). One type of headache in the posterior part of the head is a cervicogenic headache. This headache is "referred" to the head from bony structures, muscles, and other soft tissue in the neck and shoulders. Symptoms are usually one-sided and include: precipitation of head pain by neck movement or awkward neck positions, head pain when external pressure is applied to the neck or occipital region, restricted range of motion of the neck, and neck, shoulder and arm pain. Treatment for cervicogenic headache includes physical therapy, medications.

Another type is occipital neuralgia. This headache is caused by irritation or injury to two nerves that run from the upper neck to the back of the head. The irritation could be due to neck trauma, pinching of the nerves (by muscles or arthritis), and other causes. Symptoms include a piercing sharp pain that travels from the upper neck to the back of the head and behind the ears. It is usually a one sided pain but can be on both sides of the head. Treatment includes physical therapy, medications, and in some cases injections, "nerve blocks", during which a physician injects the irritated nerves with an anesthetic.

A concerning cause of neck pain associated with headache is a dissection: a small tear in the blood vessels that travel up the neck to the brain. This can occur spontaneously in people with certain conditions that affect the blood vessels, after neck trauma, or after chiropractic manipulation of the neck. The pain is often but not always associated with some sort of neurologic deficit as a dissection can often lead to a stroke. A dissection is diagnosed with a specific type of MRI test (MRA with fat saturation) or an CT angiogram.

As earlier mentioned, structural lesions (such as a mass) can cause posterior headaches.

The differential for headaches without more information is broad. If you are not normally a headache person and this is a new headache or a change from prior headaches or if you develop weakness/numbness/speech abnormalities, you should be evaluated ASAP. You may need an MRI of the brain. I do recommend that you continue following up with your primary physician as you are doing.
  
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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