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Epidural corticosteroid blockade in cervicogenic headache

P Martelletti1, F Di Sabato, M Granata

  • 1Department of Clinical Medicine, Headache Centre, University La Sapienza, Rome, Italy.

European Review for Medical and Pharmacological Sciences
|November 24, 1998
PubMed
Summary

Epidural steroid injections in the cervical epidural space provided significant pain relief for cervicogenic headache (CGH) patients. This diagnostic procedure reduced headache intensity and medication use in CGH, unlike in chronic tension headache (CTH) patients.

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Area of Science:

  • Neurology
  • Pain Medicine
  • Neurosurgery

Background:

  • Cervicogenic headache (CGH) is a common headache disorder originating from neck structures.
  • Pathophysiological mechanisms of CGH are complex and multifactorial.
  • Diagnostic and therapeutic options for CGH require further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of epidural steroid injections as a diagnostic tool for cervicogenic headache.
  • To compare the outcomes of epidural steroid injections in CGH patients versus chronic tension headache (CTH) patients.
  • To assess the impact of the procedure on pain intensity and medication consumption.

Main Methods:

  • A series of 9 CGH patients and 6 CTH patients underwent epidural steroid injections (methylprednisolone 40 mg) at the C6-C7 or C7-T1 cervical epidural space.

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  • Pain intensity was measured using the Numeric Intensity Scale (NIS).
  • Drug Consumption Index (DCI) was used to quantify medication use.

    • Main Results:

    • CGH patients experienced a significant decrease in NIS and DCI values post-injection.
    • A marked short-term (12 hours) and medium-term (4 weeks) clinical improvement was observed in CGH patients.
    • The procedure showed less pronounced effects in CTH patients, aiding in differential diagnosis.

    Conclusions:

    • Epidural steroid injection serves as an effective diagnostic blockade for cervicogenic headache.
    • This intervention offers significant short- and medium-term relief for CGH patients.
    • The procedure may help identify and manage patients with cervicogenic headache more effectively.