Serviço de Neurologia, Departamento de Clínica Médica, Complexo do Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil; Centro de Cefaleia, Clínica de Neurologia São José, São José dos Pinhais, PR, Brazil.
Serviço de Neurologia, Departamento de Clínica Médica, Complexo do Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil; Centro de Cefaleia, Clínica de Neurologia São José, São José dos Pinhais, PR, Brazil.
Best Pract Res Clin Rheumatol. 2024 Mar;38(1):101931. doi: 10.1016/j.berh.2024.101931. Epub 2024 Feb 22.
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.
颈源性头痛，近 100 年前就被描述过，直到本世纪末 Sjaastad 教授的研究才使它引起临床关注。其经典定义是源于颈椎紊乱的三叉神经症状的诱导，这得益于三叉-颈神经汇聚机制。正因为如此，它可能表现出偏头痛的几种典型特征，从而导致误诊。典型情况下，患者主诉单侧固定性头痛，起自颈部并向三叉神经分布区域放射，伴有颈部活动度降低和前屈力量减弱。头痛程度为轻至中度，呈搏动性或压迫性，伴有恶心、呕吐、畏光、畏声，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，其发作频率难以预测。挥鞭样损伤史很常见。鉴别诊断包括偏头痛和紧张型头痛。治疗包括物理疗法康复、麻醉阻滞和选择性手术。本文对所有这些方面都进行了详细阐述。
