Cervicogenic headache – How to recognize and treat

IF 4.5 2区医学 Q1 RHEUMATOLOGY

Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI:10.1016/j.berh.2024.101931

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Abstract

Cervicogenic headache, described almost 100 years ago, only had its clinical awakening at the end of the century with the work of Professor Sjaastad. Its classic definition is the induction of trigeminal symptoms from cervical disorders, thanks to trigeminocervical convergence mechanisms. For this reason, it can manifest several features typical of migraine, leading to diagnostic errors. Classically, subjects complain of fixed unilateral headaches, with cervical onset and trigeminal irradiation, associated with reduced neck mobility and flexion strength. The headache is mild to moderate, described as pulsatile or compressive, accompanied by nausea, vomiting, photophobia, phonophobia, and may present autonomic symptoms and dizziness. The pain duration varies from one day to weeks, and its frequency is unpredictable. A history of whiplash injury is common. The differential diagnosis encompasses migraine and tension-type headache. Management includes physiotherapy rehabilitation, anesthetic blocks, and selectively surgical procedures. In this article, all these aspects were extensively covered.

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颈源性头痛--如何识别和治疗。

颈源性头痛在近 100 年前就被描述过，但直到本世纪末，随着 Sjaastad 教授的研究才在临床上被唤醒。它的经典定义是，由于三叉神经与颈椎的汇聚机制，颈椎疾病诱发了三叉神经症状。因此，它可以表现出偏头痛的几个典型特征，从而导致诊断错误。通常，患者主诉固定的单侧头痛，颈部发病，三叉神经受累，伴有颈部活动度和屈曲力减弱。头痛程度为轻度至中度，描述为搏动性或压迫性，伴有恶心、呕吐、畏光、畏声，并可能出现自主神经症状和头晕。疼痛持续时间从一天到数周不等，频率难以预测。常见的病史是鞭打伤。鉴别诊断包括偏头痛和紧张型头痛。治疗方法包括物理康复治疗、麻醉阻滞和选择性手术治疗。本文对所有这些方面进行了广泛论述。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research in Clinical Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

0.00%

发文量

审稿时长

27 days

期刊介绍： Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.