[Pathomechanisms of cervical headaches]

Various types of disorders of the cervical region may produce headache. In many of these increased tension of the neck musculature plays an important role. The following mechanisms underlying headache are described and differentiated: 1. Headache due to faulty muscle pattern (stereotype) resulting in overstrain of the upper fixators of the shoulder girdle (upper part of the m.trapezius and levator scapulae); faulty respiration with the aid of the upper auxillary muscles even at rest is pointed out. 2. A forward drawn head position producing static overstrain in the posterior neck muscles and compensatory retroflexion of the cranio-cervical junction resulting in blockage in this region. 3. Anteflexion and ligament pain mainly due to faulty position at work and jolting. 4. Static disturbance in the frontal plain due to obliquity producing asymmetrical strain in the neck musculature. 5. Increased muscular tension due to psychological stress. 6. Blockage in the regions of the cervical spine, shoulder girdle and upper ribs with reflex muscular spasm. 7. Reflex spasm of the neck musculature in visceral disorders causing in addition blockage of the cervico-thoracic junction (heart, gall bladder). 8. Pain arising from the posterior arch of the atlas (here described for the first time). 9. Headache due to vertebral artery involvement. The type of headache seems to be determined rather by the individual mode of reaction than by the mechanism underlying it. As a rule a combination of mechanisms is actually found.