Cervicogenic headache: Josey's cases revisited

Vincent, Maurice; Luna, Renato A.

doi:10.1590/S0004-282X1997000500024

Abstracts

Before Sjaastad coined the term cervicogenic headache (CH) 15 years ago, neck-related headaches have been considered by different authors for many years. Even after the publication of diagnostic criteria, dispute on the clinical picture, differential diagnosis, pathophysiology and treatment of CH still persists. A paper published in 1949 by Josey reports on 6 "illustrative" cases of cervical-related headaches. Indeed, looked from a more recent perspective, those cases could eventually correspond to CH. Important topics such as the relatively high frequency, fixed unilaterality of the pain, relation to previous trauma, irradiation from the back to the forehead, normal or slightly abnormal roentgenograms, and the mechanical precipitation of attacks are some of the topics considered by Josey. The female gender was not prevalent in Josey's series. Traction and analgesics were basically the recommended treatment. CH is probably a common disorder, an idea already considered by a clinician in 1949. This syndrome was not adequately described before Sjaastad's group papers in the 80's.

cervicogenic headache; differential diagnosis

Muitos autores escreveram sobre cefaléias relacionadas ao pescoço antes da descrição da cefaléia cervicogênica (CH) por Sjaastad e col. Mesmo após a publicação de critérios diagnósticos, há controvérsias em relação ao quadro clínico, diagnóstico diferencial, fisiopatologia e tratamento da CH. Um artigo publicado em 1949 por Josey relata 6 casos "ilustrativos" de cefaléia relacionada ao pescoço, cujo quadro pode corresponder ao que hoje consideramos ser CH. Aspectos importantes como sua frequência relativamente elevada, unilateralidade fixa, relação a traumas prévios, irradiação póstero-anterior, normalidade de exames radiológicos e os mecanismos de precipitação foram considerados por Josey. O sexo feminino não foi predominante na sua casuística. Tração e analgésicos foram os tratamentos recomendados. CH é provavelmente uma desordem comum, o que já havia sido considerado neste estudo de 1949. A síndrome, entretanto, não foi completa e adequadamente descrita antes de Sjaastad.

cefaléia cervicogênica; diagnóstico diferencial

Cervicogenic headache: Josey's cases revisited

Cefaléia cervicogênica: revisão dos casos de Josey

Maurice Vincent^I; Renato A. Luna^II

^ISetor de Cefaléias, Serviço de Neurologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brasil: Professor Adjunto

^IISetor de Cefaléias, Serviço de Neurologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brasil: Estudante - Interno

ABSTRACT

Before Sjaastad coined the term cervicogenic headache (CH) 15 years ago, neck-related headaches have been considered by different authors for many years. Even after the publication of diagnostic criteria, dispute on the clinical picture, differential diagnosis, pathophysiology and treatment of CH still persists. A paper published in 1949 by Josey reports on 6 "illustrative" cases of cervical-related headaches. Indeed, looked from a more recent perspective, those cases could eventually correspond to CH. Important topics such as the relatively high frequency, fixed unilaterality of the pain, relation to previous trauma, irradiation from the back to the forehead, normal or slightly abnormal roentgenograms, and the mechanical precipitation of attacks are some of the topics considered by Josey. The female gender was not prevalent in Josey's series. Traction and analgesics were basically the recommended treatment. CH is probably a common disorder, an idea already considered by a clinician in 1949. This syndrome was not adequately described before Sjaastad's group papers in the 80's.

Key words: cervicogenic headache, differential diagnosis.

RESUMO

Muitos autores escreveram sobre cefaléias relacionadas ao pescoço antes da descrição da cefaléia cervicogênica (CH) por Sjaastad e col. Mesmo após a publicação de critérios diagnósticos, há controvérsias em relação ao quadro clínico, diagnóstico diferencial, fisiopatologia e tratamento da CH. Um artigo publicado em 1949 por Josey relata 6 casos "ilustrativos" de cefaléia relacionada ao pescoço, cujo quadro pode corresponder ao que hoje consideramos ser CH. Aspectos importantes como sua frequência relativamente elevada, unilateralidade fixa, relação a traumas prévios, irradiação póstero-anterior, normalidade de exames radiológicos e os mecanismos de precipitação foram considerados por Josey. O sexo feminino não foi predominante na sua casuística. Tração e analgésicos foram os tratamentos recomendados. CH é provavelmente uma desordem comum, o que já havia sido considerado neste estudo de 1949. A síndrome, entretanto, não foi completa e adequadamente descrita antes de Sjaastad.

Palavras-chave: cefaléia cervicogênica, diagnóstico diferencial.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Acknowledgment - The authors are indebted to Professor Sjaastad for his comments.

Aceite: 28-agosto-1997.

Dr. Maurice Vincent - Av. das Américas 1155/504 - 22631-000 Rio de Janeiro RJ - Brasil. FAX 55 21 494 3648. e-mail: vincent@unisys.com.br

1. Awerbuch MS. Whiplash in Australia: illness or injury? Med J Aust 1992;157:193-196.
2. Baila J, Karnaghan J. Whiplash headache. Clin Exp Neurol 1987;23:179-182.
3. Barré N. Sur une syndrome sympathique cervicale posterieur et sa cause frequante: l'arthrite cervicale. Rev Neurol 1926;33:1246-1248 .
4. Blau JN, Path FRC, MacGregor EA. Migraine and the neck. Headache 1994;38:88-90.
5. Blume H, Atac M, Golnick J. Neurosurgical treatment of persistent occipital myalgia-neuralgia syndrome. In Pfaffenrath V Lundberg PO, Sjaastad O (eds) Updating in headache. Berlin: Springer-Verlag 1985:24-34.
6. Bogduk N, Marsland A. On the concept of third occipital headache. J Neurol Neurosurg Psychiatry 1986;49:775-780.
7. Bovim G, Berg R, Dale LG. Cervicogenic headache: anesthetic blockades of cervical nerves (C2-C5) and facet joint (C2/ C3). Pain 1992;49:315-320.
8. Bovim G, Fredriksen TA, Stolt-Nielsen A, Sjaastad O. Neurolysis of the greater occipital nerve in cervicogenic headache: a follow up study. Headache 1992;32:175-179.
9. Bartschi-Rochaix W. Headaches of cervical origin. In Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology: Vol 5. Headache and cranial neuralgia. Amsterdam: North Holland 1968:192-203.
10. D'Amico D, Leone M, Bussone G. Side-locked unilaterality and pain localization in long-lasting headaches: migraine, tension-type headache, and cervicogenic headache. Headache 1994;34:526-530.
11. Edmeads J. The cervical spine and headache. Neurology 1988;38:1874-1878.
12. Fitz-Ritson D. Therapeutic traction: a review of neurological principles and clinical applications. J Manipulative Physiol Ther 1984;7:39-49.
13. Fredriksen TA. Studies on cervicogenic headache: clinical manifestation and differentiation from other unilateral headache forms. Thesis. Trondheim: Tapir 1989.
14. Fredriksen TA, Fougner R, Tangerud Ä, Sjaastad O. Cervicogenic headache: radiological investigations concerning head/ neck. Cephalalgia 1988;9:139-146.
15. Fredriksen TA, Hovdal H, Sjaastad O. "Cervicogenic headache": Clinical manifestation. Cephalalgia 1987;7:147-167.
16. Goadsby PJ, Knight VE, Hoskin KL. Processing of occipital pain in the caudal trigeminal nucleus: referred pain in primar) headache (Abstract). Cephalalgia 1997; 17:381.
17. Hunter CR, Mayfield FH. Role of the upper cervical roots in the production of pain in the head. Am J Surg 1949;48:743-751.
18. Jaeger B. Are "cervicogenic" headaches due to myofascial pain and cervical spine dysfunction? Cephalalgia 1989;9:157-164.
19. Jansen J, Markakis E, Rama B, Hildebrandt J. Hemicranial attacks or permanent hemicrania: a sequel of upper cervical root compression. Cephalalgia 1989;9:123-130.
20. Josey AI. Headache associated with pathologic changes in cervical part of spine. JAMA 1949;140:944-949.
21. Kerr FWL. A mechanism to account for frontal headache in cases of posterior-fossa tumors. J Neurosurg 1961;18:605-609.
22. Kerr FWL, Olafson RA. Trigeminal and cervical volleys. Arch Neurol 1961;5:171-178.
23. Knox DL, Mustonen E. Greater occipital neuralgia: an ocular pain syndrome with multiple etiologies. Trans Am Acad Ophtlalmol Otolaryngol 1975;79:513-519.
24. Maigne R: La céphalée sus-orbitaire: sa fréquente origine cervicale, son traitment par manipulations. Ann Med Phys 1968;11:241-246.
25. Maigne R. Un signe évocateur et inattendu de céphalée cervicale: "La douleur au pincé-roulé du sourcil". Ann Med Phys 1976;19:416-434.
26. Maigne R. Signes cliniques des céphalées cervicales; leur traitment. Méd et Hyg 1981;39:1174-1185.
27. Nagasawa A, Sakakibara T, Takahashi A. Roentgenographic findings of the cervical spine in tension-type headache. Headache 1993;33:90-95.
28. Nick J, Ziegler G. Étude critique des céphalées d'origine cervicale. Sem Hôp Paris 1980;56:519-524.
29. Pearce JMS. Cervicogenic headache: a personal view. Cephalalgia 1995;15:463-469.
30. Pfaffenrath V, Dandekar R, Mayer ET, Hermann G, Pöllmann W. Cervicogenic headache: results of a computer-based measurements of cervical spine mobility in 15 patients. Cephalalgia 1988;8:45-48.
31. Pfaffenrath V, Dandekar R, Pollmann W. Cervicogenic headache: the clinical picture, radiological findings and hypothesis on its pathophysiology. Headache 1987;27:495-499.
32. Pikus HJ, Phillips JM. Characteristics of patients successfully treated for cervicogenic headache by surgical decompression of the second cervical root. Headache 1995;35:621-629.
33. Rosenber WS, Swearingen B, Poletti CE. Contralateral trigeminal dysaesthesias associated with second cervical nerve compression: a Case report. Cephalalgia 1990;10:259-262.
34. Schrader H, Obelieniene D, Bovim G, Surkiene D, Mickeviciene D, Miseviciene I, Sand T. Natural evolution of late whiplash syndrome outside the medicolegal context. Lancet 1996;347:1207-1211.
35. Sjaastad O. Cervicogenic headache: the controversial headache. Clin Neurol Neurosurg 1992;94 (SuppI.):S147-S149.
36. Sjaastad O, Bovim G. Cervicogenic headache: the differentiation from common migraine. An overview. Funct Neurol 1991;6:93-100.
37. Sjaastad O, Bovim G, Stovner LJ. Laterality of pain and other migraine criteria in common migraine: a comparison with cervicogenic headache. Funct Neurol 1992;7:289-294.
38. Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. Headache 1990;31:725-726.
39. Sjaastad S, Fredriksen TS, Sand T. The localization of the initial pain of attack: a comparison between classic migraine and cervicogenic headache. Funct Neurol 1989;4:73-78.
40. Sjaastad O, Fredriksen TA, Sand T, Antonaci F. Unilaterality of headache in classic migraine. Cephalalgia 1989;9:71-77.
41. Sjaastad O, Saunte C, Hovdal H, Breivik H, Grqnbaek E. "Cervicogenic headache": an hypothesis. Cephalalgia 1983;3:249-256.
42. Vernon HT. Spinal manipulation and headaches of cervical origin. J Manipulative Physiol Ther 1989;12:455-468.
43. Vincent M, Luna R, Scandiuzzi D, Novis SAP. Greater occipital nerve blockade in cervicogenic headache. Cephalalgia (Submitted).
44. Watson DH, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical muscle performance. Cephalalgia 1993;13:272-284.

Publication Dates

Publication in this collection
07 Oct 2010
Date of issue
1997

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Awerbuch MS. Whiplash in Australia: illness or injury? Med J Aust 1992;157:193-196.

[2] 2. Baila J, Karnaghan J. Whiplash headache. Clin Exp Neurol 1987;23:179-182.

[3] 3. Barré N. Sur une syndrome sympathique cervicale posterieur et sa cause frequante: l'arthrite cervicale. Rev Neurol 1926;33:1246-1248 .

[4] 4. Blau JN, Path FRC, MacGregor EA. Migraine and the neck. Headache 1994;38:88-90.

[5] 5. Blume H, Atac M, Golnick J. Neurosurgical treatment of persistent occipital myalgia-neuralgia syndrome. In Pfaffenrath V Lundberg PO, Sjaastad O (eds) Updating in headache. Berlin: Springer-Verlag 1985:24-34.

[6] 6. Bogduk N, Marsland A. On the concept of third occipital headache. J Neurol Neurosurg Psychiatry 1986;49:775-780.

[7] 7. Bovim G, Berg R, Dale LG. Cervicogenic headache: anesthetic blockades of cervical nerves (C2-C5) and facet joint (C2/ C3). Pain 1992;49:315-320.

[8] 8. Bovim G, Fredriksen TA, Stolt-Nielsen A, Sjaastad O. Neurolysis of the greater occipital nerve in cervicogenic headache: a follow up study. Headache 1992;32:175-179.

[9] 9. Bartschi-Rochaix W. Headaches of cervical origin. In Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology: Vol 5. Headache and cranial neuralgia. Amsterdam: North Holland 1968:192-203.

[10] 10. D'Amico D, Leone M, Bussone G. Side-locked unilaterality and pain localization in long-lasting headaches: migraine, tension-type headache, and cervicogenic headache. Headache 1994;34:526-530.

[11] 11. Edmeads J. The cervical spine and headache. Neurology 1988;38:1874-1878.

[12] 12. Fitz-Ritson D. Therapeutic traction: a review of neurological principles and clinical applications. J Manipulative Physiol Ther 1984;7:39-49.

[13] 13. Fredriksen TA. Studies on cervicogenic headache: clinical manifestation and differentiation from other unilateral headache forms. Thesis. Trondheim: Tapir 1989.

[14] 14. Fredriksen TA, Fougner R, Tangerud Ä, Sjaastad O. Cervicogenic headache: radiological investigations concerning head/ neck. Cephalalgia 1988;9:139-146.

[15] 15. Fredriksen TA, Hovdal H, Sjaastad O. "Cervicogenic headache": Clinical manifestation. Cephalalgia 1987;7:147-167.

[16] 16. Goadsby PJ, Knight VE, Hoskin KL. Processing of occipital pain in the caudal trigeminal nucleus: referred pain in primar) headache (Abstract). Cephalalgia 1997; 17:381.

[17] 17. Hunter CR, Mayfield FH. Role of the upper cervical roots in the production of pain in the head. Am J Surg 1949;48:743-751.

[18] 18. Jaeger B. Are "cervicogenic" headaches due to myofascial pain and cervical spine dysfunction? Cephalalgia 1989;9:157-164.

[19] 19. Jansen J, Markakis E, Rama B, Hildebrandt J. Hemicranial attacks or permanent hemicrania: a sequel of upper cervical root compression. Cephalalgia 1989;9:123-130.

[20] 20. Josey AI. Headache associated with pathologic changes in cervical part of spine. JAMA 1949;140:944-949.

[21] 21. Kerr FWL. A mechanism to account for frontal headache in cases of posterior-fossa tumors. J Neurosurg 1961;18:605-609.

[22] 22. Kerr FWL, Olafson RA. Trigeminal and cervical volleys. Arch Neurol 1961;5:171-178.

[23] 23. Knox DL, Mustonen E. Greater occipital neuralgia: an ocular pain syndrome with multiple etiologies. Trans Am Acad Ophtlalmol Otolaryngol 1975;79:513-519.

[24] 24. Maigne R: La céphalée sus-orbitaire: sa fréquente origine cervicale, son traitment par manipulations. Ann Med Phys 1968;11:241-246.

[25] 25. Maigne R. Un signe évocateur et inattendu de céphalée cervicale: "La douleur au pincé-roulé du sourcil". Ann Med Phys 1976;19:416-434.

[26] 26. Maigne R. Signes cliniques des céphalées cervicales; leur traitment. Méd et Hyg 1981;39:1174-1185.

[27] 27. Nagasawa A, Sakakibara T, Takahashi A. Roentgenographic findings of the cervical spine in tension-type headache. Headache 1993;33:90-95.

[28] 28. Nick J, Ziegler G. Étude critique des céphalées d'origine cervicale. Sem Hôp Paris 1980;56:519-524.

[29] 29. Pearce JMS. Cervicogenic headache: a personal view. Cephalalgia 1995;15:463-469.

[30] 30. Pfaffenrath V, Dandekar R, Mayer ET, Hermann G, Pöllmann W. Cervicogenic headache: results of a computer-based measurements of cervical spine mobility in 15 patients. Cephalalgia 1988;8:45-48.

[31] 31. Pfaffenrath V, Dandekar R, Pollmann W. Cervicogenic headache: the clinical picture, radiological findings and hypothesis on its pathophysiology. Headache 1987;27:495-499.

[32] 32. Pikus HJ, Phillips JM. Characteristics of patients successfully treated for cervicogenic headache by surgical decompression of the second cervical root. Headache 1995;35:621-629.

[33] 33. Rosenber WS, Swearingen B, Poletti CE. Contralateral trigeminal dysaesthesias associated with second cervical nerve compression: a Case report. Cephalalgia 1990;10:259-262.

[34] 34. Schrader H, Obelieniene D, Bovim G, Surkiene D, Mickeviciene D, Miseviciene I, Sand T. Natural evolution of late whiplash syndrome outside the medicolegal context. Lancet 1996;347:1207-1211.

[35] 35. Sjaastad O. Cervicogenic headache: the controversial headache. Clin Neurol Neurosurg 1992;94 (SuppI.):S147-S149.

[36] 36. Sjaastad O, Bovim G. Cervicogenic headache: the differentiation from common migraine. An overview. Funct Neurol 1991;6:93-100.

[37] 37. Sjaastad O, Bovim G, Stovner LJ. Laterality of pain and other migraine criteria in common migraine: a comparison with cervicogenic headache. Funct Neurol 1992;7:289-294.

[38] 38. Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. Headache 1990;31:725-726.

[39] 39. Sjaastad S, Fredriksen TS, Sand T. The localization of the initial pain of attack: a comparison between classic migraine and cervicogenic headache. Funct Neurol 1989;4:73-78.

[40] 40. Sjaastad O, Fredriksen TA, Sand T, Antonaci F. Unilaterality of headache in classic migraine. Cephalalgia 1989;9:71-77.

[41] 41. Sjaastad O, Saunte C, Hovdal H, Breivik H, Grqnbaek E. "Cervicogenic headache": an hypothesis. Cephalalgia 1983;3:249-256.

[42] 42. Vernon HT. Spinal manipulation and headaches of cervical origin. J Manipulative Physiol Ther 1989;12:455-468.

[43] 43. Vincent M, Luna R, Scandiuzzi D, Novis SAP. Greater occipital nerve blockade in cervicogenic headache. Cephalalgia (Submitted).

[44] 44. Watson DH, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical muscle performance. Cephalalgia 1993;13:272-284.