Diagnosing cervicogenic headache

Abstract

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.

Recurrent Neck Pain and Headaches in Preadolescents Associated with Mechanical Dysfunction of the Cervical Spine: A Cross-Sectional Observational Study With 131 Students

“…[45][46][47] The findings in adults with cervicogenic headache include faulty head posture, cervical joint dysfunction (CJD), trigger points (TPs) in associated cervical paraspinal muscles, and reduction in cervical range of motion. 45,[48][49][50][51][52][53] Forward head posture is a deviation from normal which strains the upper cervical spine and can be a cause of neck pain and headache. [54][55][56] Trigger points or focal points of increased tension in a muscle, when present in the cervical spine, can also lead to neck pain and/or headaches.…”

Cervicogenic Headache: A Real Headache

“…These criteria have been validated [9•, 33, 34] and their reliability tested [35]. Criteria issued by the International Headache Society [36] unfortunately need a heavy overhaul before being impeccable [37,38]. In these criteria, facial pain is, for example, not distinguished from head pain.…”

Disability in Bank Office Workers Due to Cervicogenic Headache.

“…Cervicogenic headache is a complex syndrome caused by a variety of lesions that might reproduce pain on the contralateral side (24). Patients with bilateral headache or neck pain after whiplash injury are diagnosed as cervicogenic headache in many headache centers.…”