Abstract
Since the first attempt at setting down diagnostic criteria was made in 1990, there has been considerable progress in the field of cervicogenic headache (CEH). CEH makes up a “final common pathway” for several neck disorders that may originate at different levels of the cervical spine. CEH has been defined as being mainly a unilateral headache without sideshift; it may accordingly also be bilateral. Anesthetic blockades are mandatory for scientific work. If the pain is bilateral, it is particularly important that blockades are carried out. Pain stemming from the neck usually spreads to the oculofrontotemporal area. The most characteristic features are symptoms and signs of neck involvement (such as mechanical precipitation of attack, and so forth). Migraine without aura and tension-type headache are the most difficult differential diagnosis problems.
Similar content being viewed by others
References and Recommended Reading
Sjaastad O, Saunte C, Hovdahl H, et al.: “Cervicogenic” headache. An hypothesis. Cephalalgia 1983, 3:249–256.
Sjaastad O, Fredriksen TA, Pfaffenrath V: Cervicogenic headache: diagnostic criteria. Headache 1990, 30:725–726.
Sjaastad O, Salvesen R, Jansen J, Fredriksen TA: Cervicogenic headache a critical view on pathogenesis. Funct Neurol 1998, 13:71–74.
Michler R-P, Bovim G, Sjaastad O: Disorder in the lower cervical spine. A cause of unilateral headache? Headache 1991, 31:550–551.
Sjaastad O, Fredriksen TA, Pfaffenrath V: Cervicogenic headache: diagnostic criteria. Headache 1998, 38:442–445. Defines the current diagnostic criteria for the diagnosis of CEH; it represents a gold standard for the correct classification of CEH.
Antonaci F, Pareja JA, Caminero AB, Sjaastad O: Chronic paroxysmal hemicrania and hemicrania continua: anaesthetic blockades of pericranial nerves. Funct Neurol 1997, 12:11–15.
Bogduk N, Aprill C: On the nature of neck pain, discography and cervical zygapophysial joint blocks. Pain 1993, 54:213–217.
Fredriksen TA, Sjaastad O: Cervicogenic headache (CEH): notes on some burning issues. Funct Neurol 2000, 15:199–203.
Fredriksen TA: Studies on cervicogenic headache. Clinical manifestation and differentiation from other unilateral headache forms [PhD thesis]. Trondheim, Tapir: University of Trondheim; 1989.
Fredriksen TA, Hovdal H, Sjaastad O: “Cervicogenic headache”: clinical manifestation. Cephalalgia 1987, 7:147–160.
Pfaffenrath V, Dandekar R, Pöllmann W: Cervicogenic headache—the clinical picture, radiological findings and hypotheses on its pathophysiology. Headache 1987, 27:495–499.
Vingen VJ, Stovner LJ: Photophobia and phonophobia in tension-type headache and cervicogenic headache. Cephalalgia 1998, 18:313–318.
Delfini R, Salvati M, Passacantili E, Pacciani E: Symptomatic cervicogenic headache. Clin Exp Rheumatol 2000, 18(suppl):29–32.
Maciel JA Jr, Carmo EC, Bensabath Azoubel AC, et al.: Cefaleia cervicogenica estudio de 194 casos. Arch Neuro-psiquiatria 1994, 52(suppl O):21.
Maciel JA Jr, Carmo EC, Ruocco HH, et al.: Estudio clinico de 1229 casos. Arch Neuro-psiquiatria 1994, 52(suppl O):30.
Pereira Monteiro J: Cefaleias. Estudio epidemiologico e clinico de uma populacão urbana [PhD thesis]. Porto, Portugal: University of Porto; 1995.
Nilsson N: The prevalence of cervicogenic headache in a random population sample of 20–59 year olds. Spine 1995, 20:1884–1888.
Vincent MB, Luna RA: Cervicogenic headache: a comparison with migraine and tension-type headache. Cephalalgia 1999, 19(suppl 25):11–16. Evaluates the application of the latest diagnostic criteria of CEH and applies these criteria also in TTH and migraine. The existing criteria adequately distinguish CEH, migraine, and TTH. Site and radiation of pain, the temporal pattern, and the induction of attacks from neck posture are the most important aspects in distinguishing CEH from the other two headaches.
Antonaci F, Ghirmai S, Bono G, Nappi G: Current methods for cervical spine movement evaluation: a review. Clin Exp Rheumatol 2000, 18(suppl 19):45–52.
Bulgheroni MV, Antonaci F, Sandrini G, et al.: A 3D kinematic method to evaluate cervical spine voluntary movements in humans. Funct Neurol 1998, 3:239–245. The kinematic analysis of neck movement is useful and noninvasive and has a good-excellent reproducibility. The method, mostly used for research, can be applied also in clinical practice to evaluate neck function in cervical spine disorders.
Zwart J-A: Neck mobility in different headache disorders. Headache 1997, 37:6–11.
Jansen J: Surgical treatment of non-responsive cervicogenic headache. Clin Exp Rheumatol 2000, 18(suppl 19):67–70.
Antonaci F, Ghirmai S, Bono G, et al.: Cervicogenic headache: evaluation of the original diagnostic criteria. Cephalalgia 2001, in press.
Bovim G, Sand T: Cervicogenic headache, migraine without aura, tension-type headache. Diagnostic blockade of greater occipital and supraorbital nerves. Pain 1992, 51:43–48.
Pfaffenrath V, Dandekar R, Mayer ETH, et al.: Cervicogenic headache: results of a computer-based measurements of cervical spine mobility in 15 patients. Cephalalgia 1988, 8:45–48.
Fredriksen TA, Fougner R, Tangerud A, Sjaastad O: Cervicogenic headache. Radiological investigation concerning head/neck. Cephalalgia 1989, 9:139–146.
Stovner LJ: Headache associated with the Chiari type I malformation. Headache 1993, 33:175–181.
van Suijlekom H, de Wet HC, van den Berg SG, Weber W: Interobserver reliability of diagnostic criteria for cervicogenic headache. Cephalalgia 1999, 19:817–823. In order to distinguish patients with CEH from migraine and TTH, a “live” interview was carried out by different observers. The reliability of the criteria for CEH was similar to the one of the IHS criteria in diagnosing migraine and better than those used for diagnosing TTH.
Sjaastad O, Joubert J, Elsas T, et al.: Hemicrania continua and cervicogenic headache. Separate headaches or two faces of the same headache? Funct Neurol 1993, 8:79–83.
Bordini C, Antonaci F, Stovner LJ, et al.: Hemicrania continua, a review. Headache 1991, 31:20–26.
Sjaastad O, Bovim G: Cervicogenic headache: the differentiation from common migraine. An overview. Funct Neurol 1991, 6:93–100.
Sjaastad O, Fredriksen TA, Pareja JA, et al.: Coexistence of cervicogenic headache and migraine without aura (?). Funct Neurol 1999, 14:209–218.
Pöllman W, Keidel M, Pfaffenrath V: Headache and the cervical spine: a critical review. Cephalalgia 1997, 17:801–816.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Antonaci, F., Fredriksen, T.A. & Sjaastad, O. Cervicogenic headache: Clinical presentation, diagnostic criteria, and differential diagnosis. Current Science Inc 5, 387–392 (2001). https://doi.org/10.1007/s11916-001-0030-1
Issue Date:
DOI: https://doi.org/10.1007/s11916-001-0030-1