Headache is one of the most encountered presentations worldwide. Hence, the approach in which practitioners take in investigating, diagnosing and managing it is crucial given the high complication rates from secondary causes seen more commonly in the elderly population. We discuss a case of a patient with chronic headaches, features of occipital neuralgia and neck pain who was eventually diagnosed with Crowned Dens Syndrome (CDS). We intend to highlight this unique presentation of Calcium Pyrophosphate crystal deposition (CPPD) disease in the spine and the need to consider a broad range of differentials especially in an elderly individual presenting with headaches.
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