The Cervicogenic Headache Society describes cervicogenic headache as a dull or aching pain in the occipital, top, temporal, frontal, or orbital regions of the head, or both of these areas. It is accompanied by upper neck pain, neck pressure, neck stiffness, or upper neck pain and limited movement with activity, and is most often associated with a history of head and neck injury.
I. Diagnostic criteria of the International Headache Society.
1.The pain is fixed in the neck and occipital area and can radiate to the temporal area, the top or the ear;
2. The pain is aggravated by specific neck movements or postures;
3.Include at least one of the following.
(1) Restriction of passive neck movements,
(2) Changes in the appearance, structure, movement and passive stretch response of the neck muscles,
(3) Abnormal muscle pressure pain.
4. Radiological examination should reveal at least one of the following.
(1) abnormal extension and flexion movements;
(2) Abnormal body position;
(3) Fracture, congenital anomaly, bone tumor, rheumatoid arthritis or other pathological changes.
II. Treatment of cervicogenic headache
1.Non-invasive treatment
Drugs, psychological, transcutaneous electrical stimulation, acupuncture, tui-na, etc.
2.Minimally invasive treatment
Injection therapy (paravertebral block, occipital nerve block), epidural injection (glucocorticoid, ozone), radiofrequency destruction,
3.Surgical treatment
4.Injection therapy
Caution
1.Since the markers of the 2nd cervical transverse process are not easily accessible to the more obese, they can be treated by X-ray guided puncture.
2, the positioning of the cervical transverse process has individual differences, and there are important nerves and blood vessels in the vicinity, so attention should be paid to anatomical positioning.
3, the vertebral artery in the 2nd cervical vertebra after the lateral turn, the vertebral artery hole to the lateral opening, into the needle is easy to pierce, into the needle should be repeated back suction, strictly prevent accidental entry into the vertebral artery
4, when injecting the drug should first inject a small amount of test volume, no adverse reactions and then slowly inject, the injection process to repeatedly ask the patient’s feelings, timely detection of adverse reactions, such as dizziness needle.
5.Sometimes the drug flows forward to the supra-cervical sympathetic ganglion with transient Horner’s syndrome, which can enhance the therapeutic effect.
6.The drug should be prevented from entering the subarachnoid space by mistake during operation.