[Cervicogenic headache].
In 2004 cervicogenic headache was introduced into ICD-10 classification. The reasons of cervicogenic headache are changes within bones, soft tissue and nervous structures of cervical spine section. The pain may spread to the neck, occipital area of skull, area of jaw and eyeballs, and arms. There are many theories trying to explain spreading of the pain outside the area innervated by C1, C2 and C3 cervical roots. Their common denominator is communication between fibres running in those roots and neurons of trigeminal nerve. Many authors describe a possibility of such connection through the jelly-like nucleus of the trigeminal nerve located in the back funiculi of spinal cord. In this mechanism, the pain conducted via occipital nerves may affect activity of neurons of the trigeminal nerve and influence areas innervated by the trigeminal nerve. In general case history and physical examination are sufficient to make a diagnosis. Additional radiological and imaging examinations support this diagnosis. According to some authors, the necessary condition to make a diagnosis of cervicogenic headache is finding the changes of spondylosis nature of the cervical spine section in additional examinations. In doubtful cases, diagnostic blockade of greater occipital nerve, resulting in headache relief, supports finally a diagnosis. Any treatment includes pharmacotherapy, rehabilitation, psychotherapy and surgical methods. The purpose of the study is to view literature on cervicogenic headache which causes many diagnostic problems and hence makes it difficult to choose effective treatment.
Gasik
Robert
R
Instytut Reumatologii w Warszawie, Klinika Spondylo-Neurochirurgii i Neurologii. robertg@ir.ids.pl
D002574:Cervical Vertebrae; D006801:Humans; D051298:Post-Traumatic Headache / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D013128:Spinal Osteophytosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy