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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cervicogenic headache is a chronic hemicranial pain, usually occurring daily. This randomized, double-blind, placebo-controlled trial evaluated the effectiveness of nerve stimulator-guided occipital nerve blockade in the treatment of cervicogenic headache. The reduction in analgesic consumption was the primary outcome measure. Fifty adult patients diagnosed with cervicogenic headache were randomly divided into two equal groups of 25 patients each. All patients in both groups received greater and lesser occipital blocks, whereas only 16 patients in each group received facial nerve blockade in association with the occipital blocks. The control group received injections of an equivalent volume of preservative-free normal saline. Pain was assessed using the visual analog scale (VAS) and the Total Pain Index (TPI). Forty-seven patients entered into the final analysis as three patients were lost to follow-up. Anesthetic block was effective in reducing the VAS and the TPI by approximately 50% from baseline values (P = 0.0001). Analgesic consumption, duration of headache and its frequency, nausea, vomiting, photophobia, phonophobia, decreased appetite, and limitations in functional activities were significantly less in block group compared to control group (P < 0.05). The nerve stimulator-guided occipital nerve blockade significantly relieved cervicogenic headache and associated symptoms at two weeks following injection.
Pain Pract 2006 Jun
PMID:Occipital nerve blockade for cervicogenic headache: a double-blind randomized controlled clinical trial. 1730 15

The aim was to follow the postoperative fate of cervicogenic headache (CEH) patients with a hard-to-treat, bilateral headache, operated upon by the Smith/Robinson procedure, a stabilization and decompression operation in the cervical spine. CEH is a typically unilateral headache, but in this study, bilateral cases were deliberately selected (n=28). The patients were, otherwise, diagnosed according to the Cervicogenic Headache International Study Group (CHISG) CEH criteria. In most cases, the discs C(4-5), C(5-6) and C(6-7) were affected, and one or two discs were removed by anterior approach; an interbody fusion was carried out. Immediately postoperatively - up to 2-3 months - there was pain freedom. Secondary deterioration was reported to us in 10 patients, in nine of whom it occurred within three years. The remaining 18 patients were followed up for 2-100 months; the mean duration of improvement was 22.7 months. Bilateral, Smith/Robinson operated CEH patients seemed to fare as well as unilateral ones.
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PMID:Cervicogenic headache. Smith/Robinson approach in bilateral cases. 1736 80

Cervicogenic headache (CEH) is a unilateral headache that can be provoked by neck movement, awkward head positions or pressure on tender points in the neck. The mechanisms underlying the stimulation of pain in CEH are not clearly known. In this study, we measured serum nitrate and nitrite levels as an index of nitric oxide (NO) activity in 15 patients with CEH during headache and headache-free periods and in 15 healthy controls. Total nitrate+nitrite levels were found to be higher in CEH patients during headache periods than in healthy controls (20.7+/-3.8 micromol/l vs 14.4+/-3.6 micromol/l, p<0.001), but not in CEH patients during headache-free periods (16.1+/-2.2 micromol/l) compared with the controls (p>0.05). In the patients with CEH, serum total nitrate+nitrite levels were found to be higher during headache periods than during headache-free periods (p=0.001). It can thus be hypothesized that the changes observed are a cause of the attack rather than a consequence of the disease process.
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PMID:Is there a role for nitric oxide activity in cervicogenic headache? 1792 65

Nasopharyngeal cancer can occur in any age group and is often misdiagnosed. Cervicogenic headache (CEH) is a clinical condition, putatively originating from nociceptive structures in the neck. A patient with CEH-like symptoms occurring as a result of nasopharyngeal cancer invasion is reported. A 77-year-old man was admitted to the anesthesiology department (pain unit) with a 3-month history of severe unilateral headache. The headache began in the right part of the neck and spread to the right frontoorbital region and was always unilateral. There was no history of neck trauma, and the headache did not increase with neck movement. Analgesics were ineffective. The visual analog scale score for pain was 6. Neurological examination demonstrated tenderness over the right greater occipital nerve and reduced range of motion in the cervical spine. Cervical computerized tomography revealed a solid tumor in the right parapharyngeal region, adjacent to the C2-C3 vertebrae. To the authors' knowledge, this is the first case in the literature of tumoral invasion of nasopharyngeal cancer presenting as CEH. Cervical neuroimaging is obligatory in patients with late-onset, severe CEH.
J Orofac Pain 2008
PMID:Parapharyngeal tumor mimicking cervicogenic headache. 1835 Oct 37

In the present work, the late results of operative treatment on 60 patients, suffering from long lasting severe unilateral (n = 32) or bilateral (n = 28) cervicogenic headache, non-responsive to other treatment options, will be summarized. Cervicogenic headache (CEH) was diagnosed according to 'The Cervicogenic Headache International Study Group' guidelines. The cervical levels of affection were determined by neurological examination, magnetic resonance imaging (MRI), computed tomography (CT), anaesthetic blockades and X-ray diagnostics. The levels mainly operated on were at the C4/5, C5/6 and C6/7; one or two discs were removed. Immediately postoperatively there was pain freedom. Sixty-three per cent of the unilateral and 64% of the bilateral cases enjoyed long lasting pain freedom or improvement (> 50%). The mean observation time was 19.8 and 25.5 months, respectively. After secondary deterioration (in 37% of patients with unilateral and in 36% with bilateral CEH) and further treatments, the final mean improvement was 73% and 66%, respectively. Well-selected CEH patients may benefit from surgical intervention.
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PMID:Surgical treatment of cervicogenic headache. 1849 97

It has been reported that in Western society as many as 16% of individuals experience cervicogenic headache, which can lead to significant amounts of pain and perceived disability. Cervicogenic headache is characterized by unilateral occipital-temporal pain that is increased by neck movement; it is accompanied by cervical hypomobility, postural changes, and/or increased cervical muscle tone. This case report describes the physical therapy differential diagnosis, management, and outcomes of a patient with cervicogenic headache. The patient was a 40-year-old woman referred by her physiatrist with complaints of cervical pain and ipsilateral temporal headache. The patient presented with increased muscle tone, multiple-level joint hypomobility in the cervical and thoracic spine, muscle weakness, and postural changes. Self-report outcome measures included the Visual Analog Scale for headache pain intensity and the Neck Disability Index. Management consisted of various thrust and non-thrust manipulations, soft tissue mobilizations, postural re-education, and exercise to address postural deficits and cervical and thoracic hypomobility and diminished strength. At discharge, the patient demonstrated clinically meaningful improvements with regard to pain, disability, and headache. This case report indicates that a multimodal physical therapy treatment program may be effective in the management of a patient diagnosed with cervicogenic headache.
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PMID:Orthopaedic manual physical therapy including thrust manipulation and exercise in the management of a patient with cervicogenic headache: a case report. 1906 40

Cervicogenic headache (CGH) is a common sequela of upper cervical dysfunction with a significant impact on patients. Diagnosis and treatment have been well validated; however, few studies have described characteristics of patients that are associated with outcomes of physical therapy treatment of this disorder. A retrospective chart review of patient data was performed on a cohort of 44 patients with CGH. Patients had undergone a standardized physical therapy treatment approach that included spinal mobilization/manipulation and therapeutic exercise, and outcomes of treatment were determined by quantification of changes in headache pain intensity, headache frequency, and self-reported function. Multiple regression analysis was utilized to determine the relationship between a variety of patient-specific variables and these outcome measures. Increased patient age, provocation or relief of headache with movement, and being gainfully employed were all patient factors that were found to be significantly (P<0.05) related to improved outcomes.
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PMID:Influential variables associated with outcomes in patients with cervicogenic headache. 1906 63

Cervicogenic headache is characterised by pain referred to the head from the cervical spine. Although the International Headache Society recognises this type of headache as a distinct disorder, some clinicians remain sceptical. Laboratory and clinical studies have shown that pain from upper cervical joints and muscles can be referred to the head. Clinical diagnostic criteria have not proved valid, but a cervical source of pain can be established by use of fluoroscopically guided, controlled, diagnostic nerve blocks. In this Review, we outline the basic science and clinical evidence for cervicogenic headache and indicate how opposing approaches to its definition and diagnosis affect the evidence for its clinical management. We provide recommendations that enable a pragmatic approach to the diagnosis and management of probable cervicogenic headache, as well as a rigorous approach to the diagnosis and management of definite cervical headache.
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PMID:Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. 1974 46

Cervicogenic headache is mainly characterized by unilateral headache symptoms which arise from the neck radiating to the fronto-temporal and possibly to the supra-orbital region. Physical examination to find evidence of a disorder known to be a valid cause of headache encompasses movement tests of the cervical spinal column and segmental palpation of the cervical facet joints and soft tissues of the neck. Injection of the nervus occipitalis major is recommended after unsatisfactory results with conservative treatments (1 B+). In the case of an unsatisfactory outcome after injection of the nervus occipitalis major, radiofrequency treatment of the ramus medialis (medial branch) of the cervical ramus dorsalis can be considered (2 B+/-). If the result is unsatisfactory pulsed radiofrequency treatment of the ganglion spinale (dorsal root ganglion) of C2 and/or C3 can be considered in a study context (O).
Pain Pract
PMID:6. Cervicogenic headache. 2041 29

Cervicogenic headache (CEH) is a well-recognized syndrome. Proposed diagnostic criteria differentiate CEH from migraine and tension-type headache (TTH) in most of the cases. The best differentiating factors include side-locked unilateral pain irradiating from the back and evidence of neck involvement--attacks may be precipitated by digital pressure over trigger spots in the cervical/nuchal areas or sustained awkward neck positions. Migrainous traits may be present in some cases. Cervical lesions are not necessarily seen, and most common cervical lesions do not produce CEH. Whiplash may occasionally induce headaches. This is suspected when the pain onset and the whiplash trauma are close in time. Whiplash-related headaches tend to be short-lasting, admitting mostly a TTH or a CEH-like phenotype. Neuroimaging abnormalities are not necessarily expected in CEH. Whiplash patients must undergo cervical imaging mostly in connection with the trauma, as no abnormalities are pathognomonic in chronic cases.
Curr Pain Headache Rep 2010 Jun
PMID:Cervicogenic headache: a review comparison with migraine, tension-type headache, and whiplash. 2042 74


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