Cervicogenic Headache
| Cervicogenic Headache | |
|---|---|
| Definition | Pain that is perceived in the head but whose source is actually in the cervical spine or which is innervated by cervical nerves (a form of cervical referred pain) |
Cervicogenic headache is headache arising from the cervical region. It is treated by four main groups of health professionals: neurologists, headache specialists, pain medicine, and manual therapists. Each group has their own view.
Mechanism
There are sensory axons in C1, C2, and C2 spinal nerves that converse on dorsal horn neurons that also receive trigeminal afferents largely from the ophthalmic division. The convergence allows pain mediated in the C1, C2, or C3 nerves to be perceived in regions innervated by the trigeminal nerve (cervical - trigeminal referral). Can also have cervical - cervical referral.
Aetiology
| C1 Nerve Root | C2 Nerve Root | C3 Nerve Root | |
|---|---|---|---|
| Joints | Median C1-2 C0-C1 |
Lateral C1-2 | C2-3 ZA joint C2-3 disc |
| Ligaments | Transverse C1-2 Alar |
||
| Muscles | Prevertebral Sternocleidomastoid Trapezius Suboccipital |
Semispinalis Splenius |
Multifidus Semispinalis |
| Dura | Upper spinal cord Posterior cranial fossa |
||
| Arteries | Vertebral Internal carotid |
Diagnosis
Diagnostic criteria ICHD-3(2018)[1]
A. Any headache fulfilling criterion C
B. Clinical and/or imaging evidence of a disorder or lesion within the cervical spine or soft tissues of the neck, known to be able to cause headache
C. Evidence of causation demonstrated by at least two of the following:
- 1. headache has developed in temporal relation to the onset of the cervical disorder or appearance of the lesion
- 2. headache has significantly improved or resolved in parallel with improvement in or resolution of the cervical disorder or lesion
- 3. cervical range of motion is reduced and headache is made significantly worse by provocative manลuvres
- 4. headache is abolished following diagnostic blockade of a cervical structure or its nerve supply
D. Not better accounted for by another ICHD-3 diagnosis.
Resources
File:Cervicogenic Headache - Lancet Bogduk 2009.pdf
References
Literature Review
Literature Review
- Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf
- Articles from all years: PubMed search, Google Scholar search.
- TRIP Database: clinical publications about evidence-based medicine.
- Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,
