SYNOPSIS The clinical picture of 15 patients with “cervicogenic headache” is presented. The patients suffered from constant one‐sided headaches, upon which were superimposed acute attacks. The pain could be precipitated and intensified mechanically. It was accompanied in one third of the patients by ipsilateral lacrimation, conjunctival injection, lid edema and visual blurring. Other concomitant symptoms were phono‐ and photophobia, nausea and vomiting. A C2 blockade always led to temporary pain relief.Routine X‐rays of the cervical spine and functional radio‐graphs in flexion and extension did not reveal any findings specific for cervicogenic headache when compared to 18 control subjects. Hypotheses on the pathophysiology of cervicogenic headache are presented.

Head and neck pain are often attributed to impaired mobility of the cervical spine. No established methods exist to examine such an impaired mobility objectively in patients with cervicogenic headache. Therefore, functional roentgenograms of the cervical spine in maximum ventral and dorsal flexion were analyzed in 15 patients with cervicogenic headache and in 18 controls. Qualitative radiologic evaluation showed no significant differences in either group. A computer-based technique to assess the mobility of the cervical spine demonstrated a statistically pronounced hypomobility of the craniocervical joints C0/C2 and an impaired overall mobility of the upper cervical spine (C0-C5) in the cervicogenic headache group. The most evident hypomotility was found in segment C0/C1. Interesting was, furthermore, a probably compensatory hypermotility in segment C6/C7. These findings did not correlate with the results of the qualitative radiologic evaluation.

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