Table 1.
Diagnostic criteria of cervicogenic headache
| Cervicogenic Headache International Study Group [3] | ||
| Major criteriaa | 1. | Symptoms and signs of neck involvement |
| a. Precipitation of head pain, similar to the usually occurring one: | ||
| i. By neck movement and/or sustained awkward head positioning, and/or: | ||
| ii. By external pressure over the upper cervical or occipital region on the symptomatic side | ||
| b. Restriction of range of motion (ROM) in the neck | ||
| c. Ipsilateral neck, shoulder, or arm pain of a rather vague nonradicular nature or, occasionally, arm pain of a radicular nature. | ||
| 2. | Confirmatory evidence by diagnostic anesthetic blockade | |
| 3. | Unilaterality of the head pain, without side shift | |
| Head pain characteristics | 4. | a. Moderate-severe, non-throbbing, and non-lancinating pain, usually starting in the neck. |
| b. Episodes of varying duration | ||
| c. Fluctuating, continuous pain | ||
| Other characteristics of some importance | 5. | a. Only marginal effect or lack of effect of indomethacin |
| b. Only marginal effect or lack of effect of ergotamine and sumatriptan | ||
| c. Female sex | ||
| d. Not infrequent occurrence of head or indirect neck trauma by history, usually of more than only medium trauma | ||
| Other features of lesser importance | 6. | a. Nausea |
| b. Phonophobia and photophobia | ||
| c. Dizziness | ||
| d. Ipsilateral “blurred vision” | ||
| e. Difficulties swallowing | ||
| f. Ipsilateral edema, mostly in the periocular area | ||
| International Classification of Headache Disorders-II [5] | ||
| A. Pain, referred from a source in the neck and perceived in one or more regions of the head and/or face, fulfilling 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 known to be, or generally accepted as, a valid cause of headache | ||
| C. Evidence that the pain can be attributed to the neck disorder or lesion based on at least one of the following: | ||
| i. Demonstration of clinical signs that implicate a source of pain in the neck | ||
| ii. Abolition of headache following diagnostic blockade of a cervical structure or its nerve supply using placebo- or other adequate controls | ||
| D. Pain resolves within 3 months after successful treatment of the causative disorder or lesion | ||
aIt is obligatory that one or more of phenomena 1a-1c are present