What Causes Painful Lump at Base of Skull: Right and Left Side Symptoms & Treatment

A painful lump at the base of the skull can be very frightening. In fact, even a painless lump at the base of your skull should get you concerned. The good thing is that most such masses are not life-threatening. But just as it is with any lump anywhere in your body, chances should not be taken.

Doctors usually perform a physical exam as the first test when diagnosing lumps and body masses. The gathered details are combined with information on symptoms to settle on an informed conclusion. You can try this at home when preparing for your appointment. All the same, medical diagnosis has many advantages over self-diagnosis. In fact, never base a decision not to seek treatment on self-diagnosis results.

Causes of lump at base of skull

Any of the following can be responsible for a lump at the base of your skull:

Lymph nodes

Contrary to what it may seem like, lymph nodes are not only located in areas such as the groin, armpit, behind the ear, under the chin and throat. They occur throughout the body, including on the back of the skull under the skin. It is only that the named locations contain much larger groupings. Lymph nodes can be felt under the skin as firm but slightly movable lumps. In the advent of a disease or infection, lymph nodes usually swell. Swollen lymph nodes are more noticeable and tend to form painful lumps. A hard lump on back of head can be a swollen lymph node.


Lipomas are growths that originate in fatty tissue. They are noncancerous tumors which feel like round, soft, rubbery and movable lumps under the skin. A lipoma can take months or even years to mature and stop growing. Generally, lipomas are not painful but can cause pain if they have grown large enough to push against a nerve or a blood vessel.

Delivery disorders

Infants have soft skull bones which can overlap over each other during delivery. This is a very important feature, for it allows the head to pass through birth canal. Sometimes, cranium bones can overlap over each other to form a bruise which later hardens into a bone knot at the base of the skull. This is normal and should not make you concerned.

Occipital neuralgia irritation

Occipital neuralgia are two occipital nerves located in the scalp muscles. A lump at the base of skull left side or right side can develop due to irritation on these nerves. In most cases, the lump will be accompanied by a shooting or tingling pain.


An injury such as being hit in the head with a blunt object can cause a lump at the base of the skull. Small injuries will probably cause damage to blood vessels and cause a hematoma lump. Severe injuries may cause damage and small fractures on the skull, and cause a bone bruise. Bone bruises can also cause a lump in pelvic area male symptoms or in any other bone to which an injury has been sustained.

Boils and abscesses

Boils are soft lumps filled with pus that originate in hair follicles. The skin surrounding a boil is usually tender and warm. Large boils cause abscesses which can lead to symptoms such as fever, swollen lymph nodes and pain.


Cysts are common causes of lumps under the skin and breast lumps. On the base of the skull, cysts can be of the following types:

  • Pillar cysts – these originate in hair follicles and oil glands. Sometimes, a hair follicle can become clogged with excess sebum. As more sebum gets secreted, it accumulates to form a sac-like pouch under the skin. This type of cysts feels soft and slightly movable.
  • Epidermoid cysts – epidermal cells on top skin layers are naturally shed off throughout a person’s lifetime. Sometimes, epidermal cells can move deeper into the skin through damaged hair follicles or cracks on skin. Since the cells will keep multiplying and hair will keep growing, a hard lump filled with keratin forms under the skin. This is known as an epidermoid cyst.
  • Congenital cyst – congenital cysts appear in infants and are formed before birth. They form lumps at the base of the skull. Normally, these cysts are not harmful but can get infected in rare cases. Infants can also have these cysts in the neck and in front of the ears.
  • Aneurysmal bone cysts – these are types of cysts that form in bones. They are filled with blood but not cancerous. The aneurysm referred to in this case is a bit different from the one that causes a lump in lower left abdomen due to an inflamed aorta.


A tumor at the base of the skull can originate in scalp skin cells or inside the skull. Such a tumor can be caused by:

  • Meningiomas – Meningiomas is a tumor that originates in the membranes that cover the spinal cord and brain. Only about 10% of all meningiomas lumps are cancerous. If a meningioma grows on the brain, it pushes the brain out rather than growing within it.
  • Pituitary tumors – these are tumors that grow in the pituitary gland. This is a gland located at the base of the skull directly behind the bridge of the nose. It controls the endocrine system and most functions of the hypothalamus. Depending on the type of tumor, symptoms may or may not occur. For example, some tumors make the pituitary gland excessively active while others render it functionless. The former causes symptoms such as increased metabolism and high body temperature.
  • Acoustic neuromas – these are noncancerous tumors that develop on nerves located in your ears which aid in maintaining balance and hearing. Tumors in these nerves may cause symptoms such as loss of hearing and lack of balance.
  • Bone growths – a bone growth usually originates in the surface of a bone or on cartilage. They grow slowly and are not cancerous. You can also have a hard, big lump under tongue due to a bone growth.

It is unlikely that a tumor in the brain will cause a lump at the base of the skull. This is because the skull is very rigid.

All the same, large tumors may persistently push against the skull to the point of causing a lump. Malignant brain tumors do not usually spread. However, it is still possible to have a lump on lung or central nervous system caused by malignant cells originating in the brain.

Symptoms of lumps at base of skull

Symptoms that manifest depend on the cause and severity of the lump. Lumps caused by injuries will be painful and may cause swelling. Cystic lumps are rarely painful and feel slightly movable under the skin. Lipomas are soft movable lumps that form under the skin. Lymph nodes are pea-sized firm lumps that grow a bit bigger when swollen. In infants, quite a number of harmless lumps may appear.

Tumors are characterized by slow or gradual growth. Even if not cancerous, they can be of some problems such as pressing against nerves, blood vessels or even the brain itself.

Diagnosis and treatment for lump at base of skull

Benign lumps such as lipomas and lymph nodes do not require treatment. If necessary, lipomas can be removed or drained. Swollen lymph nodes will resolve once the infection or disease causing them has been eradicated.

Cysts do not resolve without treatment. If bothersome or painful, the best removal method is surgery. Your doctor can also inject with anti-inflammatory medications. Benign cysts in infants usually resolve with time.

Tumors can be quite dangerous. The best approach method to deal with them is to surgically remove them. If malignant, other forms of treatment such as chemotherapy and radiotherapy will also be incorporated in treatment.

When to see a doctor for a painful lump at base of skull

You can have a lump at the base of the skull on the right side, left side or on skull top of head. Since the skull extends to the bridge of nose and behind ears, masses on these areas can be termed as lumps on the skull.

See your doctor if a lump on your skull is accompanied by pain, swelling, fever, swollen lymph nodes and general weakness. Also, get medical help if a lump gradually gets bigger or persists for more than two weeks.

Lumps caused by injury on the base of the skull are potentially dangerous. They can cause a blood clot inside the skull or even on the brain. See your doctor for X-ray imaging in case you have been involved in an accident or has been hit with a blunt object on your head. This is especially if you notice symptoms such as dull headache, sharp pain in one side of your head, loss of vision, memory loss and confusion.


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