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KMID : 0911820080090010021
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Korean Journal of Headache
2008 Volume.9 No. 1 p.21 ~ p.26
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Pathophysiology and Interventional Treatment Cervicogenic Headache
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Moon Dong-Eon
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Abstract
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Cervicogenic headache is pain perceived in the head but referred from a primary source in the cervical spine. The physiologic basis for this pain is convergence betw een trigeminal afferents and afferents from the upper three cervical spinal nerves. The possible sources of cervicogenic headache lie in the structures innervated by the C 1 to C 3 spinal nerves, and include the upper cervical synovial joints, the upper cervical muscles, the C2-3 disc, the vertebral and internal carotid arteries, and the dura m ater of the upper spinal cord and posterior cranial fossa. Anaesthetic blocks m ay be necessary to confirm the diagnosis of cervicogenic headache, showing that the source pain is in the neck. Differential diagnosis is sometim es a challenge because cervicogenic headache can be m istaken for other form s of unilateral headache, especially unilateral m igraine w ithout aura. R adiofrequency current is simply a tool used to create discrete thermal lesions in neural pathways in order to interrupt transmission. In pain medicine, radiofrequency lesions have been used to interrupt nociceptive pathways at various sites. W ith the development alternatives such as neuromodulation and intrathecal opioid infusion technologies. This article introduces the technique of anesthetic blockade and radiofrequency lesioning as an interventional treatment m odality of cervical pain.
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KEYWORD
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Cervicogenic headache, N eck pain, H eadache
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