Clinical features, risk factors, and a nomogram for predicting refractory cervicogenic headache: a retrospective...

Area of Science:

• Neurology
• Pain Medicine
• Headache Disorders

Background:

• Cervicogenic headache (CEH) presents complex symptoms, making treatment difficult and sometimes leading to refractory cases.
• Identifying predictors for treatment unresponsiveness is crucial for managing CEH effectively.

Purpose of the Study:

• To identify risk factors predicting the development of refractory cervicogenic headache.
• To determine predictors of unresponsiveness to greater occipital nerve blocks in CEH patients.

Main Methods:

• A retrospective cohort study of 82 patients diagnosed with cervicogenic headache between January 2022 and March 2024.
• Greater occipital nerve block was administered, and data were analyzed using logistic regression to identify prognostic indicators.

Main Results:

• 46 patients (56%) experienced headache relief, while 36 (44%) did not respond to greater occipital nerve blocks.
• Multivariate analysis identified C2-C3 sensory loss (OR=13.10), bilateral headache (OR=7.99), multiple pain sources (OR=5.51), and limited cervical range of motion (OR=13.05) as significant predictors of unresponsiveness.

Conclusions:

• Patients with C2-C3 sensory loss, bilateral headaches, and severely limited cervical spine mobility may have poor outcomes with occipital nerve block therapy.
• Pain originating from multiple sources is associated with less favorable treatment responses in cervicogenic headache.