Occipital headache (Chiari headache)

What it is

The occipital (Chiari) headache is a headache located at the back of the head and upper neck — the occipital region. It is the most common symptom of symptomatic Chiari malformation type I, reported in a large majority of symptomatic patients.

Understanding Occipital headache (Chiari headache)

This headache is typically felt at the back of the lower skull and upper neck, often described as pressure-like, and characteristically triggered or worsened by maneuvers that transiently raise pressure — coughing, sneezing, straining, bending over, laughing, or bearing down. This pattern reflects the disrupted CSF flow at the foramen magnum, where the pressure changes are not smoothly equalized. The Chiari headache is distinctive enough that its presence is an important clue when evaluating whether Chiari is symptomatic, though headaches are common and have many causes. Recognizing the typical pattern helps distinguish a Chiari-related headache from other headache types. Understanding the Chiari headache clarifies the condition's most common and characteristic symptom.

Why it matters

Understanding the Chiari headache helps families recognize the condition's most common symptom — an occipital headache worsened by coughing or straining — which is an important clue in evaluating whether Chiari is symptomatic.