Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment

@article{Bogduk2009CervicogenicHA,
  title={Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment},
  author={Nikolai Bogduk and Jayantilal Govind},
  journal={The Lancet Neurology},
  year={2009},
  volume={8},
  pages={959-968}
}
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235 Citations
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13
Background Citations
84
Methods Citations
10

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235 Citations

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The neck and headaches.
  • N. Bogduk
  • Medicine, Psychology
    Neurologic clinics
  • 2014
Treatment of Cervicogenic Headache : New Insights on the Treatment of Pain in the Neck
TLDR
To achieve pain control of cervicogenic headache, it would appear best to employ a multimodal approach with pharmacological, manipulative, anesthetic, and invasive interventions.
A Pain in the Neck: Review of Cervicogenic Headache and Associated Disorders
TLDR
The purpose of the current review is to provide an overview of the diagnosis and treatment of cervicogenic headache, and discussion focuses on associated disorders including whiplash, a common cause of cerviogenic headache.
Occipital Neuralgia and Cervicogenic Headache: Diagnosis and Management
TLDR
The anatomy, clinical features, unique diagnostic considerations, and management approaches relating to ON and CGH are reviewed, indicating that anesthetic nerve blocks may have a dual role in both supporting diagnosis and providing pain relief.
Sources of Cervicogenic Headache Among the Upper Cervical Synovial Joints.
TLDR
Controlled diagnostic blocks can establish the source of pain in the majority of patients presenting with probable cervicogenic headache, with C2-3 being the most common source.
Therapeutic options for cervicogenic headache
TLDR
Several physical therapy interventions are proposed for CeH, with spinal manipulation and soft tissue interventions being the most commonly used, however, the lack of solid evidence of positive effects and risks of serious complications for spinal manipulation should be considered in favor of otherPhysical therapy interventions associated with less risk.
Headache and Neck
  • M. Vincent
  • Medicine
    Current pain and headache reports
  • 2011
TLDR
There is no definite, universal treatment for CeH yet, but options include physical therapy, preventive medicines, anesthetic blocks, denervation procedures, and surgery.
Headache and neck
TLDR
Criteria such as mechanical precipitation of pain by digital pressure on neck trigger points and specific movements, strictly unilateral pain without side-shift, diffuse unilateral shoulder and arm pain, pain starting posteriorly and spreading anteriorly should be integral part of the classification.
Cervicogenic Headache Hypothesis and Anterior Cervical Decompression as a Treatment Paradigm
TLDR
The anterior cervical spine surgery has shown promise in the treatment of cervicogenic headaches and this success has hinted at a ventral source of nociceptive pathology.
Radiofrequency Ablation for Treatment of Cervicogenic Headache: Where do we stand?
TLDR
The results of the observational study by Cohen et al suggest that selecting patients based on key clinical variables may increase the chance of treatment success for cervical facet RF, and one explanation for the inconsistency lies in the nature of CH.
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References

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Cervicogenic headache: a critical review of the current diagnostic criteria
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Basic research on the convergence of upper cervical spine afferents and trigeminal pathways has given the possibility to explain referred pain as the underlying mechanism of the perception of cervicogenic headache.
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The chances of diagnosing a definite CEH are significantly more frequent in patients presenting with unilateral pain that also begins as a neck pain, and an improvement of the current diagnostic IHS criteria might make it possible to avoid the existing, partial overlap of CEH with HN and M.
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The late results of operative treatment on 60 patients, suffering from long lasting severe unilateral or bilateral cervicogenic headache, non-responsive to other treatment options, will be summarized to suggest well-selected CEH patients may benefit from surgical intervention.
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Injections of depot methylprednisolone into the region of the GON and LON produced complete relief of headache in 169 out of 180 patients with CEH for a period ranging from 10 to 77 days, suggesting that local steroid injections by blocking the cervico-trigeminal relay, can arrest other forms of unilateral headache.
Cervicogenic Headache. Radiological Investigations Concerning Head/Neck
TLDR
The different investigations showed no typical characteristic pathology in the group of patients with cervicogenic headache and no indication of a common therapeutic approach could be derived from these investigations.
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