Occipital headaches stemming from the lateral atlanto-axial (C1-2) joint.
Studies in normal volunteers have demonstrated that the lateral atlanto-axial joints (C1-2) are capable of causing pain in the occiput, but few clinical studies have validated this source of occipital headache. The present study tested the null hypothesis that the lateral atlanto-axial joints are not a common source of occipital headache. Patients presenting with occipital pain underwent diagnostic blocks of their lateral atlanto-axial joints if they demonstrated clinical features presumptively suggestive of a C1-2 origin for their pain. Of 34 patients investigated, 21 obtained complete relief of their headache following diagnostic blocks, indicating that a C1-2 source of occipital pain is not rare. The clinical features used to select patients for blocks, however, had a positive predictive value of only 60%. Further study of headaches from C1-2 seems justified in order to establish more definitively the prevalence of this condition and how it might become better recognized in practice.
Aprill
C
C
Magnolia Diagnostics, New Orleans, Louisiana, USA.
Axinn
M J
MJ
Bogduk
N
N
D000328:Adult; D000368:Aged; D001175:Arthrography; D001268:Atlanto-Axial Joint / Q000294:innervation*; D001623:Betamethasone; D002045:Bupivacaine; D002574:Cervical Vertebrae / Q000294:innervation; D003937:Diagnosis, Differential; D005260:Female; D020773:Headache Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D009777:Occipital Bone / Q000294:innervation; D010147:Pain Measurement / Q000379:methods; D013127:Spinal Nerves / Q000187:drug effects / Q000503:physiopathology
D001623:Betamethasone; D002045:Bupivacaine