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Cervical Headaches
| Question | Answer |
|---|---|
| Trigeminocervical Nucleus | The TCN is located in the midbrain and is the anatomical area through which all head pain is directed. It is responsible for pain transmission and considered the nociceptive nucleus for the head & upper neck |
| Overlap of Spinal Afferents | The overlap of the spinal affarents and the Trigeminal nerve and upper 3 spinal nerves permists The Trigeminal nerve to recieve afferent input from C1-3 nerves. Any structures innervated by C5,7,9,10 or C1-3 can cause head pain |
| Opthalmic Division | Supplies the anterior 2/3 of the head, forehead and orbit and is the most caudal distribution in the TCN thus the greatest overlap between C1-3 spinal nerves |
| Cervical Plexus | Greater occipital N--> 1/2 of post. scalp to vertex Lesser Occipital N--> Scalp posterior and superior to ear Greater Auricular N--> Scalp, small area posterior to ear |
| Cause of Forehead headache | Sinusitis, eye or nose disorder, or spasm in suboccipital area |
| Cause of side of head headache | Migraine,eye or ear disorder, auriculotemporal neuralgia |
| Cause of Occipital headache | myofacial problems, HD, eye strain, hypertension, occipital neuralgia |
| Cause of parietal headaches | hysteria, constipation, meningitis, tumor |
| Cause of face headaches | Maxillary sinusitis, dental issue, Trigeminal neuralgia, tumor |
| Cause of morning headache | sinusitis, sleeping position, alcohol, migraine, hypertension |
| Cause of afternoon headache | eye strain or muscle strain |
| Cause of night headache | Nephritis, osteomyelitis, intracranial disease |
| Cause when you have headache when bending | sinusitis |
| cause when you have headache when lying horizontal | migraine |
| Types of headache that could have cerival component | migraine, tension, cervicogenic |
| Migraine headache | 1. usually no more than twice a week 2. not exacerbated by activity 3. can have mood alteration, photophobia, phonophobia, nausea and vomiting 4. temporoparietal or frontotemporal 5. mostly women |
| Types of headache that could have cerival component | migraine, tension, cervicogenic |
| Migraine headache | 1. usually no more than twice a week with unilateral pulsating 2. not exacerbated by activity 3. can have mood alteration, photophobia, phonophobia, nausea and vomiting 4. temporoparietal or frontotemporal 5. mostly women |
| Tension headaches | 1. bilateral steady ache in frontal or temporal 2. aggrevated by stress 3. mostly women |
| Cervicogenic headaches | 1. comes from nocioceptive source in tissue innervated by cervical nerves(usually 1 or more tissues is affected) 2. can involve lower cervical spine 3. Cervical spine may or may not exhibit mechanical dysfunction |
| Possible causes of cervicogenic headaches | a cervical lesion may NOT be the cause, instead it could be 1. Coexisting 2. Incidental 3. Contributory 4. Trigger thus treatment of cervical problem will not help the headache |
| clinical features of cervicogenic headaches | 1. Females > males 2. frontal, retro-orbital, occipital, temporal 3. unilateral dull ache with tender articular pillars 4. posture or position change could help |
| Trigger points | 1. SCM 2. Upper trapezius 3. Splenius capitus cervicis 4. Semispinalis 5. suboccipital 6. pterygoids 7. Temporalis 8. masseter |
| Possible red flags | 1. sudden onset with vomiting and nect stiffness 2. first or worst headache of life 3. night headaches 4. sudden change in chronic pattern headaches 5. aggravated by intrathecal pressure 6. history of trauma |
Created by:
badkins6
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