Diagnosing cervicogenic headache.
Diagnosing cervicogenic headache.
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DOI：
10.1007/s10194-006-0277-3
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发表时间：
2006-06
影响因子：
7.4
通讯作者：
Chimento, Pierluigi
中科院分区：
文献类型：
--
作者：
Antonaci, Fabio;Bono, Giorgio;Chimento, Pierluigi
颈椎疾病可导致头痛的概念已有一个多世纪的历史，但关于颈源性头痛（CEH）的潜在机制、体征和症状以及最合适的治疗方法仍存在很大争议。CEH通常是单侧头痛，可由颈部运动、尴尬的头部位置或颈部压痛点的压力引起。头痛可以持续数小时或数天，疼痛通常被描述为钝痛或刺痛。上颈神经根会聚于三叉神经束尾侧核是CEH最普遍接受的神经生理学解释。在大多数情况下，CEH是由颈椎上部的病理引起的，但病理的类型和确切位置在个体病例中有很大差异。麻醉阻滞可能是必要的，以确认CEH的诊断，显示疼痛的来源是在颈部。鉴别诊断有时是一个挑战，因为CEH可能被误认为是其他形式的单侧头痛，特别是无先兆的单侧偏头痛。颈部运动的神经影像学和运动学分析可能有助于诊断困难的CEH。
The notion that disorders of the cervical spine can cause headache is more than a century old, yet there is still a great deal of debate about cervicogenic headache (CEH) in terms of its underlying mechanisms, its signs and symptoms, and the most appropriate treatments for it. CEH is typically a unilateral headache that can be provoked by neck movement, awkward head positions or pressure on tender points in the neck. The headaches can last hours or days, and the pain is usually described as either dull or piercing. Convergence of the upper cervical roots on the nucleus caudalis of the trigeminal tract is the most commonly accepted neurophysiological explanation for CEH. In most cases, CEH is caused by pathology in the upper aspect of the cervical spine, but the type and exact location of the pathology varies substantially among individual cases. Anaesthetic blocks may be necessary to confirm the diagnosis of CEH, showing that the source of pain is in the neck. Differential diagnosis is sometimes a challenge because CEH can be mistaken for other forms of unilateral headache, especially unilateral migraine without aura. Neuroimaging and kinematic analysis of neck motion may aid in diagnosing difficult CEH.