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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thermal thresholds were measured in the face (first and second trigeminal area), over the mastoid process (C2-3 area), and in the hands in patients with migraine (n=17), cluster headache (n=22), and cervicogenic headache (n=20). Significant symptomatic versus nonsymptomatic side differences were generally not found for any headache group. Cluster headache patients had significantly higher warm thresholds than controls (n=24) for most of the cephalic points. Cervicogenic headache patients had significantly higher warm and cold thresholds than controls (n=56) at several cephalic and noncephalic points. Warm thresholds over the mastoid process on the symptomatic side were higher in cervicogenic headache patients compared to the other groups. In migraine patients, thermal thresholds were similar to those in controls. Thus, we found no evidence of focal or unilateral peripheral somatic nerve dysfunction involving C or A-delta fibers in any of the studied headache groups, although a C2-3 root dysfunction in cervicogenic headache could not be excluded. A bilateral central sensory dysfunction in cluster headache and cervicogenic headache may be hypothesized but a generalized peripheral dysfunction can also explain our results.
Cephalalgia 1998 Dec
PMID:Thermal sensitivity in unilateral headaches. 995 Jun 24

Cervicogenic headache (CeH) has been treated successfully by ventral decompressive surgery and segmental fusioning. Usually ventral fusioning is performed during one operation on one or two neighbouring segments only. We performed dorsal decompressive laminotomy and laminoplasty on eight patients with more than two segmental degenerative diseases narrowing the cervical spinal canal. The bilateral sawn laminae were moved dorsally and fixed with miniplates and screws. Six patients were relieved from headache and two improved postoperatively. Ventral decompressive surgery and fusioning frees from irritating mechanisms all nociceptively innervated tissues such as disc, dorsal ligament, facet joint capsule, nerve root and dura. On the other hand, after dorsal laminoplasty only the dura is freed from irritation or compression. Relief of headache after this surgical treatment shows that the dura, with its nociceptive nerve fibres, could be an important trigger mechanism of CeH.
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PMID:Laminoplasty--a possible treatment for cervicogenic headache? Some ideas on the trigger mechanism of CeH. 1056 18

Cervicogenic headache (CEH) is a neck-generated headache syndrome. Attacks may be similar to migraine (M) or tension-type headache (TTH). In order to test the accuracy of the IHS diagnostic criteria for M and episodic TTH and of the criteria for CEH of Sjaastad et al., 33 CEH, 65 M, and 29 TTH were evaluated according to the CEH criteria, and CEH patients were tested for M and TTH according to the IHS criteria. Only 30% of the CEH patients met the criteria for M, 3% met the criteria for TTH, and 66% were neither M nor TTH. The mean number of criteria met, sex, age, and age of onset were also analysed, and the results indicate an inequality among these three headache types. The most important differentiating aspects were the site and radiation of the pain, the temporal pattern, and the induction of attacks from neck posture, movements, and/or digital pressure. CEH clearly differs from M and TTH. Existing criteria adequately distinguish the three headaches.
Cephalalgia 1999 Dec
PMID:Cervicogenic headache: a comparison with migraine and tension-type headache. 1066 12

It is well known that migraine with aura may coexist with various unilateral headaches, like cluster headache and chronic paroxysmal hemicrania. It may also coexist with cervicogenic headache. The diagnosis of migraine without aura ("common migraine") poses greater problems than the diagnosis of migraine with aura. Cervicogenic headache diagnosis also poses problems when these two headaches coexist, since they have symptoms in common. Therefore, the scientific demonstration of coexistence of migraine without aura and cervicogenic headache is bound to be a difficult task. In the present study, migraine without aura and cervicogenic headache seemed to coexist in 4 patients (3 F and 1 M, mean age 50). Attacks with migraine characteristics fulfilled the IHS and IASP migraine criteria. Out of a maximum of 13 migraine characteristics based on the IHS/IASP migraine criteria, such as unilaterality, aggravation on minor physical activity, etc., none of the patients presented less than 11, as opposed to a mean of < or = 4 of these criteria in the cervicogenic type attacks. A similar system, based on criteria such as: reduction of range of motion in the neck, mechanical precipitation of attacks, etc., was also developed for cervicogenic headache. The mean number of cervicogenic headache criteria was 4.3 (out of a total of 5) in the "cervicogenic part of the picture", as opposed to 1.5 (1.8 if laterality is considered, see text) in the "migraine part of the picture". Drug regimens and anaesthetic blocks also showed different results in the two different headaches in the same patient. All in all, this study seems to support a coexistence of the two headache types.
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PMID:Coexistence of cervicogenic headache and migraine without aura (?). 1071 94

Cervicogenic headache (CEH) is a relatively common but often overlooked disorder. There is sufficient evidence to support this category and the existing diagnostic criteria are adequate. Subgroups may exist and the clinical picture sometimes may be similar to that of other headache disorders, however. The pathophysiology of this condition and its relationship with other headache syndromes remain to be determined. Migrainous features may occur in some patients.
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PMID:Cervicogenic headache: clinical aspects. 1082 79

The concept of headache originating/starting in the neck is revised and considered in the light of previous descriptions of syndromes and entities and with reference to the current diagnostic systems for the classification of headache and other head pain. Cervicogenic headache (CEH), a clinical picture recently described by Sjaastad and coworkers and listed in the International Association for the Study of Pain (IASP) Classification, is analyzed, also taking into consideration its diagnostic criteria in terms of sensitivity and specificity. The problem of a differential diagnosis with migraine, tension headache and other well defined forms of unilateral headaches is discussed with reference to a case series of 114 patients who were selected based on their adherence to two fundamental criteria: (i) side-locked unilaterality of pain; and (ii) pain starting in the neck and spreading to the fronto-orbital area. Based on the results, these simple criteria can contribute to a preliminary identification of possible CEH cases that may then undergo a sequence of clinical and instrumental procedures in order to confirm the diagnosis and, possibly, to localize the level(s) of dysfunction in the cervical spine which may be the target for therapeutic investigations, whether invasive or non-invasive.
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PMID:Unilateral headaches and their relationship with cervicogenic headache. 1082 80

Cervicogenic headache is a little-known clinical condition whose true importance has only recently been recognized. A number of causes may lie at the basis of the onset of headache (symptomatic cervicogenic headache). However, despite exhaustive attempts, sometimes it is not possible to identify a clear cause responsible for the onset of the syndrome (primitive cervicogenic headache). The genesis of symptomatic cervicogenic headaches sometimes may be easy to identify as a result of a close, pre-existing, cause-effect relationship (i.e. trauma). On other occasions it may be much more laborious to pinpoint the pathology responsible for headache (some cranio-cervical anomalies, etc.). Clinically, it is necessary to perform a thorough preliminary clinical and anamnestic evaluation which can orient subsequent investigations to achieve a diagnosis in the least time possible with the minimum discomfort to the patient and his relatives, not to mention lower costs for society.
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PMID:Symptomatic cervicogenic headache. 1082 84

Cervicogenic headache (CEH) is a relatively common form of headache arising from the neck structures. The pathophysiology probably results from various local pain-producing factors such as intervertebral dysfunction, with a no less important role played by the frequent coexistence of a history of head traumas. This report represents a series of pathophysiological studies in CEH patients and the results achieved by pharmacological treatment of the disease. Interleukin-1 beta (IL-1 beta) and Tumour Necrosis Factor alpha (TNF-alpha) exert their multifunctional biological effects by promoting and increasing the molecular events of cellular inflammation. We found that the cytokine pattern of CEH patients is--similar to cluster headache--biased towards an inflammatory status. Higher levels of both IL-1 beta and TNF-alpha were detected in the sera of CEH patients than the levels in patients with migraine without aura and in healthy subjects. There were also differences between the spontaneous and mechanically worsened pain phases of CEH. Nitric oxide (NO) synthase is also activated in cervicogenic headache. No change in NO metabolites levels has been observed after NO donor administration. This behaviour is clearly different from that observed in migraine and tension headache patients. We conclude that the high degree of cytokine and NO production in CH may depend on the differing pathophysiological mechanisms at work in CEH than in other forms of headache.
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PMID:Proinflammatory pathways in cervicogenic headache. 1082 85

Cervicogenic headache (CEH) has been said to be common among patients with idiopathic headache, but no information exists as to its prevalence among those who have not suffered whiplash or head injury. This study was designed to answer this question and in addition to determine whether headache relief could be achieved by blockade of the occipital nerves (greater and lesser occipital--GON, LON) in the upper neck, on the side habitually affected by the headache. Among 796 patients with idiopathic headache, 128 or 16.1% were found to be suffering from CEH. They were predominantly female, as in the case of migraine, older than the migrainous group (49.5 years as against 34.7 years), respectively, and with a monthly headache frequency of 18, against 6.9 in the case of migraine. 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, the mean duration of relief being 23.5 days. However, similar relief of headache could be achieved in patients with attacks of strictly unilateral migraine or cluster headache, suggesting that local steroid injections by blocking the cervico-trigeminal relay, can arrest other forms of unilateral headache.
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PMID:Cervicogenic headache: prevalence and response to local steroid therapy. 1082 89

Cervicogenic headache is a relatively common pain syndrome related to functional and/or degenerative alterations of the cervical spine tract. Administration of steroid represents an effective therapy for this headache, due to the anti-inflammatory effects combined with its direct analgesic effects on the C fibers. The epidural injection of steroids, while requesting skilled personnel for its execution, gives short term (2-month) pain relief with few risks or side effects. Moreover, epidural steroids allow reduction of analgesic drug consumption.
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PMID:Epidural steroids as a pharmacological approach. 1082 90


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