بسم الله الرحمن الرحیم

CERVICO GENIC HEADACHE

DIANGNOSTIC CRITERIA

A. Pain, referred from a source in the neck and perceived in one or more regions of the head and/or face, fulfills criteria C and D. B. Clinical, laboratory, and/or imaging evidence of a disorder or lesion within the cervical spine or soft tissues of the neck is known to be, or generally accepted as, a valid cause of headache. C. There is evidence that the pain can be attributed to the neck disorder or lesion based on at least one of the following: 1. Demonstration of clinical signs that implicate a source of pain in the neck. 2. Abolition of headache following diagnostic block of a cervical structure or its nerve supply using placebo or other adequate controls. Abolition of headache means complete relief of headache, indicated by a score of 0 on a visual analog scale. D. Pain resolves within 3 months after successful treatment of the causative disorder or lesion.

ETIOLOGY

1. atlanto- occipital joint 2. atlanto- axial joint 3 1. atlanto- occipital joint 2. atlanto- axial joint 3. c2-c3 zygapo physical joint 4. c2-c3 interver tebral disc 5. vpper cervical roots nerves

DIFFERENTIAL DIAGNOSIS

1. tension headache 2. migraine headache 3. cervico genic headache 4 1. tension headache 2. migraine headache 3. cervico genic headache 4. poste rior fossa lesions 5. vertebral artery lesions

NEUROPHYSIOLOGY

FIGURE : The trigemino-cervical complex FIGURE : The trigemino-cervical complex. (Reprinted with permission from Cleveland Clinic)

ATLANTO AXIAL JOINT PAIN 1. POST TRAUMATIC 2. OSTEO ARTHAITIS

CLINICAL PRESENTATION

DIAGNOSTIC BLOCK WITH INTRA –ARTICULAR INJECTION OF ANESTHETICS

TREATMENT: 1. INTRA-ARTICULAR STEROIDS 2. R.F LESIONING OF CAPSULE 3. AAJ ARTHRODESIS

C2-C3 ZYGAPO PHYSICAL JOINT THIRD OCCIPITAL HEADACHE

TREATMENT: THIRD OCCIPITAL NERVE NEUROLYSIS

OCCIPITAL NEURALGIA

A. Paroxysmal stabbing pain, with or without persistent ache between paroxysms, in the distribution(s) of the greater, lesser, and/or third occipital nerves. B. Tenderness over the affected nerve. C. Pain eased temporarily by local anesthetic block of the nerve.

ETIOLOGY: GREATER OCCIPITAL NERVE ENTRAPMENT EMERGING TRAPEZIUS

TREATMENT: PHARMACO THERAPY OCCIPITAL NEUROSTIMULATION SURGICAL NERVE RELEASE

C2 NEURALGIA

INTERMITANT LANCINATING PAIN WITH LACRIMATION CILIARY INJECTION AND RHINORRHEA

DIAGNOSIS: SELECTIVE C2 ROOT BLOCK

ETIOLOGY: AAJ DISORDERS

با سپاس...