Cervicogenic Headache

Samer Narouze, M.D., M.Sc.
Program Director
Pain Medicine Fellowship
Pain Management Department

Staff, Center for Neurorestoration
Neurosurgery Department
Cleveland Clinic
Cleveland, OH

Introduction - TOP

Cervicogenic headache was originally defined as unilateral headache characterized by pain exacerbation with neck movement or pressure over tender points in the neck.  It is often associated with a reduction in the range of movement of the cervical spine. The headache occurs in non-clustering episodes and is usually non-throbbing in nature, originating from the neck and spreading over the oculofrontotempotal regions.1-3

However, these clinical criteria are not definitive enough to make a diagnosis of cervicogenic headache, as it is sometimes difficult to differentiate clinically between cervicogenic headache, migraine, and specially tension-type headache.4-6   Cervicogenic headache can be unilateral or bilateral.7

Now considered the major criterion in the diagnosis of cervicogenic headache is patient response to diagnostic blockade of the nerves supplying the cervical structures or to an intra-articular injection of local anesthetic into the culprit joint.7    

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