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Diagnosing cervicogenic headache.

Fabio Antonaci1, Giorgio Bono, Pierluigi Chimento

  • 1Department of Neurological Sciences, C. Mondino Foundation, University of Pavia, Via Mondino 2, 27100 Pavia, Italy. neuronet@libero.it

The Journal of Headache and Pain
|April 1, 2006
PubMed
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Cervicogenic headache (CEH) originates from the cervical spine, often presenting as unilateral pain triggered by neck movements. Diagnosis can be challenging, requiring methods like anesthetic blocks and imaging.

Area of Science:

  • Neurology
  • Pain Medicine
  • Orthopedics

Background:

  • The link between cervical spine disorders and headache is long-standing but debated.
  • Cervicogenic headache (CEH) is characterized by unilateral head pain, often triggered by neck movement or specific tender points.
  • The exact mechanisms, symptoms, and optimal treatments for CEH remain subjects of ongoing discussion.

Purpose of the Study:

  • To explore the neurophysiological underpinnings of cervicogenic headache.
  • To discuss the diagnostic challenges and methods for identifying CEH.
  • To review the varied pathologies in the upper cervical spine associated with CEH.

Main Methods:

  • Review of the neurophysiological explanation involving upper cervical roots and the trigeminal nucleus caudalis.

Related Experiment Videos

  • Discussion of diagnostic techniques including anesthetic blocks for pain source confirmation.
  • Consideration of neuroimaging and kinematic analysis for complex cases.

    • Main Results:

    • The convergence of upper cervical roots onto the trigeminal nucleus caudalis is the leading neurophysiological theory for CEH.
    • Pathology in the upper cervical spine is the common cause, though variable in type and location.
    • Anesthetic blocks can confirm the neck as the pain source, aiding diagnosis.

    Conclusions:

    • CEH is a distinct headache disorder linked to cervical spine pathology.
    • Accurate diagnosis requires differentiating CEH from other unilateral headaches, such as migraine.
    • Advanced diagnostic tools like imaging and motion analysis can assist in challenging CEH cases.