Vascular compression of the C2 and C3 roots--yet another cause of chronic intermittent hemicrania?

Two male patients had a history of right-sided headache attacks occurring daily and spreading from the occipital to the frontal region. The attacks were accompanied by ciliary injections on the symptomatic side, increased lacrimation and, in one case, by rhinorrhea. The pain was relieved with vasoconstricting preparations (ergotamine) and provoked with vasodilating medications (nitroglycerine). A selective conduction anaesthesia of the C2 nerve root in one case and of the C2 and C3 roots in the other, temporarily relieved the pain. At operation, vessels were found which compressed these roots. Since decompression of the nerve roots, 3 years and 1 year ago respectively, the patients have remained free of pain.