Nick J, Ziegler G
Sem Hop. 1980;56(11-12):519-24.
When confronted to an occipito-cervical headache too often cervical etiology is proposed. Several cervical mechanisms are however possible: 1) neuralgic mechanism for the three first cervical segments. Any vertebral or intra-spinal lesion may affect the first three posterior roots; 2) muscular mechanism affecting cranio-cervical muscles: role of posture; spinal unbalance; traumatic or acute rheumatic discovertebral lesion; 3) vascular (arterial) mechanism, much more unfrequent like vertebro-basilar insufficiency. The role of vegetative (sympathetic) system is practically inexistant. So cervicarthrose play no role when there is no arthro-muscular involvement with painful limitation of cervical movements. But the most important causes of posterior cephalalgia are not of cervical intracranial origin: they are tumours of posterior fossa; high blood pressure, and above all tension headache of psychic origin.
当面对枕颈性头痛时，人们常常认为病因在颈椎。然而，有几种颈椎相关机制是可能的：1）头三个颈椎节段的神经痛机制。任何椎体或椎管内病变都可能影响前三对后根；2）影响颅颈肌肉的肌肉机制：姿势的作用；脊柱失衡；创伤性或急性风湿性椎间盘病变；3）血管（动脉）机制，如椎基底动脉供血不足则更为少见。自主（交感）系统的作用实际上并不存在。因此，当没有关节肌肉受累且颈椎活动无疼痛性受限的情况时，颈椎关节病不起作用。但后头部疼痛的最重要原因并非源于颈椎或颅内：它们是后颅窝肿瘤、高血压，尤其是精神源性紧张性头痛。
