Pöllmann W, Keidel M, Pfaffenrath V
Marianne Strauss-Klinik, Berg.
Nervenarzt. 1996 Oct;67(10):821-36. doi: 10.1007/s001150050060.
Headache in association with the cervical spine is often misdiagnosed and treated inadequately due to confusing and varying terminology. Primary headaches such as tension-type headache and migraine are incorrectly categorized as "cervicogenic" merely because of their occipital localization. Cervicogenic headache described by Sjastaad presents as a unilateral headache of fluctuating intensity increased by movement of the head and typically radiating from occipital to frontal regions. Definition, pathophysiology, differential diagnosis and therapy of cervicogenic headache shall be demonstrated. Ipsilateral blockades of the C2/ C3 root and/or the major occipital nerve allow a differentiation between migraine and other primary headache syndromes. Neither pharmacological nor surgical or chiropractic procedures lead to an improvement or remission of cervicogenic headache. Pain of various anatomical regions possibly join into a common anatomical pathway then presenting as cervicogenic headache, which should therefore be understood as a homogeneous but also unspecific pattern of reaction.
由于术语混乱且多变,与颈椎相关的头痛常常被误诊且治疗不充分。原发性头痛,如紧张型头痛和偏头痛,仅仅因为其枕部定位而被错误地归类为“颈源性”。Sjastaad所描述的颈源性头痛表现为单侧头痛,强度波动,头部运动时加重,通常从枕部放射至额部。将阐述颈源性头痛的定义、病理生理学、鉴别诊断和治疗。C2/C3神经根和/或枕大神经的同侧阻滞可区分偏头痛和其他原发性头痛综合征。无论是药物治疗、手术治疗还是整脊治疗,都无法改善或缓解颈源性头痛。各个解剖区域的疼痛可能汇入一条共同的解剖通路,进而表现为颈源性头痛,因此应将其理解为一种同质但也非特异性的反应模式。