Introduction
Almost everyone has had headaches at some point in their lives. These can vary in severity and can occur in different parts of the head. The experience of headaches is strongly influenced by the person affected, which is why over 250 types of headaches have now been medically defined.
In the majority of cases, the causes are either unknown or harmless. Rarely is there a more serious disease behind the pain symptomatology that requires competent treatment. Back headaches are therefore usually caused by a harmless cause, but can also be an indication of a more serious illness. The pain is caused, as with other localizations, by the involvement of the components of the head, which, unlike the brain mass, can feel pain. These are the skull bone, the head muscles, the meninges, as well as the scalp and the locally running vessels and nerves.
Causes
Fall injuries are an important cause of back headaches. Often the back of the head hits the underside of the head when falling to the ground, which can cause various types of injury with varying intensity. These range from a bruise (haematoma), a concussion to a craniocerebral trauma with a cerebral haemorrhage or a fracture of the skull bone.
If the pain does not improve even after some time and emergency pain treatment, imaging diagnostics (computed tomography/CT, magnetic resonance imaging of the head/MRI) should be performed in any case to rule out a severe injury. If the patient initially feels better, but after some time a severe headache reoccurs, a cerebral hemorrhage (often epidural or subdural hemorrhage, rarely subarachnoid hemorrhage) may have occurred in connection with the fall, which often requires surgical treatment. Occipital neuralgia is another cause of occipital pain.
This is a nerve pain caused by the three so-called occipital nerves at the back of the head. These nerves supply the back of the skull and mediate the sensitivity and pain in this area. The causes of occipital neuralgia are again manifold and range from muscle tension, gout and diabetes mellitus to space-occupying processes such as bleeding, inflammation or tumors.
A cervical vertebra syndrome (cervical syndrome/acute cervical syndrome) and tension headaches can themselves be the triggers for occipital headaches on the one hand, but on the other hand they can cause occipital neuralgia, which is the cause of the pain symptoms. Both clinical pictures are often connected with tension of the neck and occipital muscles. Changes in the cervical spine or permanent poor posture can also lead to corresponding symptoms.
A rarely occurring phenomenon is post-coital headaches – headaches that occur after sexual intercourse. It can also be back headaches, which are most likely to occur in men after sexual intercourse due to the enormous effort involved. Once the exertion subsides, the headache subsides again.
Further diagnostic procedures should be initiated if the pain lasts for a very long time or is of unusually severe intensity. There may be a problem of the heart or blood vessels which should be examined by a physician. Serious causes of occipital pain include cerebral hemorrhage.
The most dangerous type is subarachnoid hemorrhage. As a result of an injury or a ruptured aneurysm (malformation or bulging of a vessel), blood runs between the two inner meninges. The patient suddenly suffers from severe headaches and often the neck area stiffens.
Since such a cerebral hemorrhage can lead to serious consequential damage, an emergency doctor must be called immediately and the bleeding treated in a clinic. Another disease that can cause headaches and neck stiffness is meningitis. Rarely, however, is there a local limitation (pain exclusively in the back of the head), but rather a diffuse distribution of pain.
Additional symptoms should also be taken seriously. If the person suffering from occipital pain also reports dizziness, nausea or visual disturbances, these are alarming indications. There may be a concussion or a more serious craniocerebral trauma.
