Ko Hak-Cheol, Son Byung-Chul
Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Asian J Neurosurg. 2018 Oct-Dec;13(4):1229-1232. doi: 10.4103/ajns.AJNS_197_17.
Although C1-C3 upper cervical radiculopathy can cause a headache, most case reports are occipital neuralgia (ON), not headache. Here, we report a unique case of chronic temporo-occipital headache due to C3 radiculopathy. A 62-year-old male presented with a chronic left-sided temporo-occipital headache with duration of 4 years. The headache was aching and pressure like in nature. It had a typical radiating pattern on every occasion. It started in the posterior temporal area above the ear. It then extended to retroauricular area, then suboccipital area, and lateral neck. No hypesthesia, allodynia, or limitation in neck motion was noted. Myelographic computed tomography revealed a left-sided C2/C3 foraminal stenosis. Subsequent foraminotomy and decompression of the left C3 completely alleviated the chronic left-sided temporo-occipital headache. Unilateral C3 radiculopathy can cause chronic temporo-occipital headache besides ON. The present case might be a typical example of "headache attributed to upper cervical radiculopathy" (A11.2.4) rather than cervicogenic headache according to the International Classification of Headache Disorders, 3 edition (beta version).
虽然C1 - C3节段的上颈椎神经根病可引起头痛，但大多数病例报告为枕神经痛（ON），而非头痛。在此，我们报告一例因C3神经根病导致慢性颞枕部头痛的独特病例。一名62岁男性，患有持续4年的慢性左侧颞枕部头痛。头痛性质为酸痛和压迫感。每次发作都有典型的放射模式。始于耳部上方的颞后部区域，然后扩展至耳后区域、枕下区域和颈部外侧。未发现感觉减退、异常性疼痛或颈部活动受限。脊髓造影计算机断层扫描显示左侧C2/C3椎间孔狭窄。随后进行的左侧C3椎间孔切开减压术完全缓解了慢性左侧颞枕部头痛。除枕神经痛外，单侧C3神经根病可导致慢性颞枕部头痛。根据《国际头痛疾病分类》第3版（beta版），本病例可能是“归因于上颈椎神经根病的头痛”（A11.2.4）而非颈源性头痛的典型例子。
