Cervicogenic Headache: Diagnostic Criteria

IntroductionThe term cervicogenic headache (CEH) refers to a head pain condition that has its origin in the neck. Such ideasheadache of nuchal origin -must have occupied the minds of men for centuries. A more systematic search for such headaches seems to have been made only from the early stages of last century [1]. The reason for the lack of breakthrough of such ideas was probably the vague, indistinct descriptions of the headache in the original works, and confusion with other headaches, like migraine without aura and tension-type headache, none of which were properly defined at that time. Cardinal symptoms, beside the headache, were supposed to be dizziness, visual disturbances and tinnitus -the attacks in part lasting two to three hours. This constellation of symptoms has little to do with the CEH picture that we know today. Clinicians who conscientiously were searching for cases of headache stemming from the neck on those premises could be easily and widely misled. An overview of the early description could be the basis for a better understanding of the current terminology as far as CEH is concerned. J Headache Pain (2005) 6:462-466 DOI 10.1007 Concepts leading to the definition of the term cervicogenic headache: a historical overview

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“…This group has met annually ever since. Its diagnostic criteria were first published in 1990 [29] and revised in 1998 [30].…”

Section: Kerr and Olafsonmentioning

confidence: 99%

Concepts leading to the definition of the term cervicogenic headache: a historical overview

et al. 2005

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“…In these cases, a positive response to appropriate anaesthetic blockades might be essential also in clinical practice (not only in scientific diagnostic work-up), mainly in order to exclude tension-type headache (TTH). Even in the more regular unilateral case, pain may eventually spread to the opposite side when headache becomes severe, while remaining stronger on the original side [5]. The typical unilaterality is probably clearest at attack/exacerbation onset.…”

Section: Introductionmentioning

confidence: 98%

“…The pain of attack starts in the neck, eventually spreading to the oculofrontotemporal area, where, during the acme, it may be as strong as or even stronger than in the occipital region [2,5]. The duration of pain episodes is most frequently longer than in common migraine; the pain intensity is moderate, non-excruciating, unlike cluster headache and usually of a non-throbbing nature.…”

Section: Introductionmentioning

confidence: 99%

“…The duration of pain episodes is most frequently longer than in common migraine; the pain intensity is moderate, non-excruciating, unlike cluster headache and usually of a non-throbbing nature. Table 1 Cervicogenic headache: CEHISG diagnostic criteria [5] Major criteria I. Symptoms and signs of neck involvement* Ia.…”

Section: Introductionmentioning

confidence: 99%

“…*It is obligatory that one or more of the phenomena Ia-Ic are present Autonomic symptoms and signs, like photo-and phonophobia, nausea, vomiting and ipsilateral periocular oedema, are infrequent -and mild if present -and some of them, like vomiting, are clearly less marked than in common migraine [2,3,5,[8][9][10]. In a study by Vingen and Stovner [11], light-and sound-induced discomfort and pain thresholds have been measured in patients with TTH, CEH and in headache-free controls.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosing cervicogenic headache

2006

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The notion that disorders of the cervical spine can cause headache is more than a century old, yet there is still a great deal of debate about cervicogenic headache (CEH) in terms of its underlying mechanisms, its signs and symptoms, and the most appropriate treatments for it. CEH is typically a unilateral headache that can be provoked by neck movement, awkward head positions or pressure on tender points in the neck. The headaches can last hours or days, and the pain is usually described as either dull or piercing. Convergence of the upper cervical roots on the nucleus caudalis of the trigeminal tract is the most commonly accepted neurophysiological explanation for CEH. In most cases, CEH is caused by pathology in the upper aspect of the cervical spine, but the type and exact location of the pathology varies substantially among individual cases. Anaesthetic blocks may be necessary to confirm the diagnosis of CEH, showing that the source of pain is in the neck. Differential diagnosis is sometimes a challenge because CEH can be mistaken for other forms of unilateral headache, especially unilateral migraine without aura. Neuroimaging and kinematic analysis of neck motion may aid in diagnosing difficult CEH.

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A 47-Year-Old Woman With Tension-type Headaches

Welch¹

2001

JAMA

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Cervicogenic Headache: Diagnostic Criteria

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Concepts leading to the definition of the term cervicogenic headache: a historical overview

Concepts leading to the definition of the term cervicogenic headache: a historical overview

Diagnosing cervicogenic headache

A 47-Year-Old Woman With Tension-type Headaches

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