Clinical diagnosis and treatment of headache is pain in one of the
most common diseases, according to statistics, at least in every
personal life experience a headache. Because the correct diagnosis
and treatment, many patients with chronic headaches is the
"depression" or even "mental illness" hat, serious impact on their
work, learning and living, to patients and their families to the
spirit and heavy financial burden. It is worth noting that in recent
years the incidence of juvenile headache the rising trend of their
learning, mental, and adverse consequences for growth. Currently, the
incidence of cervical headache on the rise, but many doctors and
patients for cervicogenic headache does not have a full understanding
of. Tianjin Medical University General Hospital in addition to pain
section Chen runner-up
In the past that headache are composed only of the intracranial
diseases, treatment is mainly uses the "piecemeal" mode, many
patients with nonsteroidal anti-inflammatory drugs, head of
physiotherapy and pain points injection for the treatment does not
improve after illness, forming the "sick headache, the doctor also
headache" embarrassing situation. 1991 Sjasstad first proposed
"cervicogenic headache", thinks that the cervical vertebral Canal
pathological changes inside and outside can cause headache symptoms,
headache of gratitude, diagnosis and treatment presents significant
challenges. The so-called "headache" and "neural vascular headache"
concept will gradually be eliminated and "cervicogenic headache"
concept more and more people's attention.
Anatomical study found that the No. 1 ~ 4 cervical nerves and
headache closely these neural interconnected together, greater
occipital nerve pillow small neural and greater Auricular, conduction
pillow, top, places even facial sensation.
1. under the pain of the site, nature, signs, and be able to exclude
other diseases cause headaches
(1) clinical performance
1) age in 20-60 years old, female, and long-term career related
paperwork, etc. Cervicogenic headache on the issue of long-term desk
people, such as accountants, offices staff, computer workers, welders,
students, and long sweater, play mahjong is also a high incidence of
2) early-occipital, ear, ear discomfort, lower gradually appear dull
aching pain, swelling, or until the pain. Pain scale to the top of
the forehead, temporal.
3) accompanied by symptoms may have tinnitus, ear swelling, eye-like
swelling, nausea, stiff neck soreness, many patients may have nausea,
vomiting, severe cases may have mental sluggishness and flaccid.
4) pain, chronic persistent process rendered shiqingshizhong, cold,
tired, emotion may increase, the rest can be mitigated. As the course
progresses, the gradual increase trend is rendered.
1) next to the ear below cervical, mastoid has obvious tenderness in
the rear, top of the neck, temporal and neck may be a pain.
2) patient can have a local feel, some patients suffering from side
of smell, taste,.
The top 3) pressure test and test can be positive for the head.
(3) secondary checks
1) x-ray may have cervical degenerative manifestations, such as
physiological curvature of the cervical vertebral Hyperostosis,
disappearance, intervertebral foramen narrow, narrow, intervertebral
Ridge ligament calcification, etc.
2) CT visible hyperosteogeny, spinal stenosis, disc prolapse or
highlight changes, etc.
3) cervical MRI may show disc degeneration, highlight the oppression
of epidural or spinal cord and nerve root has no neck oppression, and
there are no holes in the vertebral artery stenosis and other changes,
is a diagnosis of cervical headache preferred imaging methods.
(4) to exclude other causes of headache caused by reasons such as
eye-and ear-derived, rhinogenic headache, and exclude intracranial,
vascular malformations, intracranial infection, and other causes of
2. the treatment method
(1) General treatment for symptoms of lighter, course shorter
patients can take a rest, traction and physical therapy, can be
combined with oral non-carrier anti-inflammatory drugs.
(2) cervical paraspinal injection 2 anti-inflammatory analgesic,
0.26% lidocaine 10mg triamcinolone.
(3) symptoms a heavier to hospital treatment, using CT-guided
minimally invasive neural intervention analgesia, namely through the
epidural catheter clearance before continuing to give anti-
inflammatory analgesic drugs to eradicate spinal inflammation, then
injected collagenase oppression of nerve root of the disc. In
addition, there is a plate, collagenase, ozone dissolved, neck nerve
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