Cefaléia cervicogênica relato de um caso

Vincent, Maurice; Bovim, Gunnar

doi:10.1590/S0004-282X1991000100015

Resumos

A produção de cefaléias a partir de anormalidades no pescoço nunca foi sistematizada a ponto de permitir o estudo de sua patogenia, embora fosse fato conhecido há muitos anos. Sjaastad et al. descreveram, em 1983, grupo de pacientes com uma cefaléia uniforme e estereotipada. Os ataques se caracterizavam por dor moderada, unilateral sem mudança de lado, de longa duração, recorrendo em poucas semanas. A cefaléia podia ser provocada por certos movimentos do pescoço ou por compressão de pontos desencadeadores ali localizados. A dor se iniciava rua região cervical, irradiando-se para as áreas órbito-fronto-temporal e/ou facial. A denominação «cefaléia cervicogênica» (CC) foi proposta para esta entidade. Sua fisiopatogenia não é completamente conhecida. Bloqueios da raiz C2 e do nervo grande occipital eliminam a dor. Apresentamos um caso de CC, fazendo alguns comentários acerca do seu quadro clínico, fisiopatologia e tratamento.

It has been known for many years that headaches can originate from abnormalities in the neck. However, their clinical pictures were never sufficiently systematized, at least not in order to permit the research on their pathogenesis. Sjaastad et al. described in 1983 a group of patients with a very uniform and stereotyped headache. Attacks of mild, longlasting, unilateral head pain without sideshift, occurred every few weeks. The headache could be provoked by neck movements, such as extension, rotation or lateral flexion, as well as by external pressure towards trigger points in the neck. It usually started back in the neck, eventually spreading to the ipsilateral orbito-frontal-temporal or facial areas. The denomination «cervicogenic headache» (CH) was proposed. Its pathophysiology is presently unknown. The C2 and occipital nerve blockages eliminate the pain. We present a CH case and make some comments on its clinical picture, pathophysiology, and treatment.

CONTENTS CONTEÚDO

Maurice Vincent^I; Gunnar Bovim^II

^INeurologista, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (Serviço do Prof. Sérgio Novis) - Trabalho realizado no Hospital da Universidade de Trondheim, Noruega

^IINeurologista, Hospital da Universidade de Trondheim (Regionsykehuset i Trondheim), Noruega (Serviço do Prof. Ottar Sjaastad) - Trabalho realizado no Hospital da Universidade de Trondheim, Noruega

RESUMO

A produção de cefaléias a partir de anormalidades no pescoço nunca foi sistematizada a ponto de permitir o estudo de sua patogenia, embora fosse fato conhecido há muitos anos. Sjaastad et al. descreveram, em 1983, grupo de pacientes com uma cefaléia uniforme e estereotipada. Os ataques se caracterizavam por dor moderada, unilateral sem mudança de lado, de longa duração, recorrendo em poucas semanas. A cefaléia podia ser provocada por certos movimentos do pescoço ou por compressão de pontos desencadeadores ali localizados. A dor se iniciava rua região cervical, irradiando-se para as áreas órbito-fronto-temporal e/ou facial. A denominação «cefaléia cervicogênica» (CC) foi proposta para esta entidade. Sua fisiopatogenia não é completamente conhecida. Bloqueios da raiz C2 e do nervo grande occipital eliminam a dor. Apresentamos um caso de CC, fazendo alguns comentários acerca do seu quadro clínico, fisiopatologia e tratamento.

SUMMARY

It has been known for many years that headaches can originate from abnormalities in the neck. However, their clinical pictures were never sufficiently systematized, at least not in order to permit the research on their pathogenesis. Sjaastad et al. described in 1983 a group of patients with a very uniform and stereotyped headache. Attacks of mild, longlasting, unilateral head pain without sideshift, occurred every few weeks. The headache could be provoked by neck movements, such as extension, rotation or lateral flexion, as well as by external pressure towards trigger points in the neck. It usually started back in the neck, eventually spreading to the ipsilateral orbito-frontal-temporal or facial areas. The denomination «cervicogenic headache» (CH) was proposed. Its pathophysiology is presently unknown. The C2 and occipital nerve blockages eliminate the pain. We present a CH case and make some comments on its clinical picture, pathophysiology, and treatment.

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Full text available only in PDF format.

Agradecimento - Os autores agradecem os valiosos comentários do Prof. Ottar Sjaastad.

Dr. Maurice Vincent - Rua General Glicério 183/301 - 22251 Rio de Janeiro RJ - Brasil.

1. Bartschi-Rochaix W. Headaches of cervical origin. In Vinken PJ, Bruyn GW (eds) : Handbook of Clinical Neurology. Amsterdam: North-Holland, 1968, Vol 5, p 192-203.
2. Carella A. Slight anomalies of the atlas: their pathogenetic meaning. Neuroradiology 1972, 3:224-227.
3. Eagle WW. Elongated styloid process: further observations and a new syndrome. Arch Otolaryngol 1948, 47:630-640.
4. Fredriksen TA. Cervicogenic headache: the forehead sweating pattern. Cephalalgia 1988, 8:203-209.
5. Fredriksen TA. Studies on Cervicogenic Headache. University of Trondheim, Department of Medicine. Trondheim: TAPIR, 1989.
6. Fredriksen TA, Fougner R, Tangerud A, Sjaastad O. Cervocogenic headache: radiological investigations concerning head/neck. Cephalalgia 1989, 9:1-8.
7. Fredriksen TA, Hovdahl H, Sjaastad O. <
8. Fredriksen TA, Wysocka-Bakowska MM, Bogucki A, Antonaci F. Cervicogenic headache: pupillometric findings. Cephalalgia 1988, 8:93-103.
9. Grimson BS, Thompson HS. Raeder's syndrome : a clinical review. Surv Ophthalmol 1980, 24:199-210.
10. Headache Classification Committee of the International Headache Society. Classification and Diagnostic Criteria for Headache Disorders, Cranial Neuralgias and Facial Pain. Cephalalgia 1988, 8 : (S7).
11. Jaeger B. Are «cervicogenic» headaches due to myofascial plain and cervical spine dysfunction? Cephalalgia 1989, 9:157-164.
12. Krabbe AA. Cluster headache: a review. Acta Neurol Scand 1986, 74:1-9.
13. Lance JW, Antony M. Neck-tongue syndrome on sudden turning of the head. J Neurol Neurosurg Psychiat 1980, 43:97-101.
14. Lovshin LL. Carotidynia. Headache 1987, 17:192-195.
15. Mianzoni GC, Terzano MG, Bono G, Micieli G, Martucci N, Nappi G. Cluster headache: clinical findings in 180 patients. Cephalalgia 1983, 3:21-30.
16. Massey EW, J. Elongated styliod process (Eagle's syndrome) causing hemicrania. Headache 1979, 19:339-344.
17. Pfaffenrath V. Cervicogenic headache and its differential diagnosis. In Ferrari MD, Lataste X (eds) : Migraine and Other Headaches. Park Ridge, USA. Parthenon, 1989, p 161-177.
18. Pfaffenrath V, Dandekar R, Pöllmann W. Cervicogenic headache : the clinical picture, radiological findings and hypotheses on its pathophysiology. Headache 1987, 27:495-499.
19. Sjaastad O. Chronic paroxismal Hemicrania (CPH). In: Vinken PJ, Bruyn GW, Klawans HLi, Rose FC (eds) : Handbook of Clinical Neurology. Amsterdam: Elsevier 1986, Vol 4 (48), p 257-266.
20. Sjaastad O, Dale I. Evidence for a new(?) treatable headache entity: a preliminary report. Headache 1974, 14:105-108.
21. Sjaastad O, Dale I. A new(?) clinical headache entity: chronic paroxysmal hemicrania. Acta Neurol Scand 1976, 54:140-159.
22. Sjaastad O, Fredriksen TA, Sand T. The localization of the initial pain of attack: a comparison between classic migraine and cervicogenic headache. Functional Neurol 1989, 4:1-6.
23. Sjaastad O, Fredriksen TA, Sand T, Antonaci F. Unilaterality of headache in classic migraine. Cephalalgia 1989, 9:1-7.
24. Sjaastad O, Fredriksen TA, Stolt-Nielsen A. Cervicogenic headache, C2 rhizopathy, and occipital neuralgia: a connection? Cephalalgia 1986, 6:189-195.
25. Sjaastad O, Saunte C, Hovdahl H, Breivik H, Gr0nbaek E. «Cervicogenic» headache: an hypothesis. Cephalalgia 1983, 3:249-256.
26. Sjaastad O, Saunte C, Salvesen R, Fredriksen TA, Seim A, R0e, OD, Fostad K, Lobben OP, Zhao MJ. Shortlasting, unilateral neuralgiform headache attacks with conjunctival injection, tearing, sweating and rhinorrhea. Cephalalgia 1989, 9:147-156.
27. Sjaastad O. de Souza Carvalho D, Zhao JM. «Mild» cluster Headache(?). Chephalalgia 1988, 8:121-126.
28. Sjaastad O, Spierings ELH. Hemicrania continua: another headache absolutely responsive to indomethacin. Cephalalgia 1984, 4:65-70.
29. Vincent M. Hemicrania paroxística crônica : aspectos clínicos. Rev Bras Neurol 1989, 25:69-75.

Cefaléia cervicogênica relato de um caso

Cervicogenic headache: report of a case

Datas de Publicação

Publicação nesta coleção
22 Fev 2011
Data do Fascículo
Mar 1991

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Bartschi-Rochaix W. Headaches of cervical origin. In Vinken PJ, Bruyn GW (eds) : Handbook of Clinical Neurology. Amsterdam: North-Holland, 1968, Vol 5, p 192-203.

[2] 2. Carella A. Slight anomalies of the atlas: their pathogenetic meaning. Neuroradiology 1972, 3:224-227.

[3] 3. Eagle WW. Elongated styloid process: further observations and a new syndrome. Arch Otolaryngol 1948, 47:630-640.

[4] 4. Fredriksen TA. Cervicogenic headache: the forehead sweating pattern. Cephalalgia 1988, 8:203-209.

[5] 5. Fredriksen TA. Studies on Cervicogenic Headache. University of Trondheim, Department of Medicine. Trondheim: TAPIR, 1989.

[6] 6. Fredriksen TA, Fougner R, Tangerud A, Sjaastad O. Cervocogenic headache: radiological investigations concerning head/neck. Cephalalgia 1989, 9:1-8.

[7] 7. Fredriksen TA, Hovdahl H, Sjaastad O. <

[8] 8. Fredriksen TA, Wysocka-Bakowska MM, Bogucki A, Antonaci F. Cervicogenic headache: pupillometric findings. Cephalalgia 1988, 8:93-103.

[9] 9. Grimson BS, Thompson HS. Raeder's syndrome : a clinical review. Surv Ophthalmol 1980, 24:199-210.

[10] 10. Headache Classification Committee of the International Headache Society. Classification and Diagnostic Criteria for Headache Disorders, Cranial Neuralgias and Facial Pain. Cephalalgia 1988, 8 : (S7).

[11] 11. Jaeger B. Are «cervicogenic» headaches due to myofascial plain and cervical spine dysfunction? Cephalalgia 1989, 9:157-164.

[12] 12. Krabbe AA. Cluster headache: a review. Acta Neurol Scand 1986, 74:1-9.

[13] 13. Lance JW, Antony M. Neck-tongue syndrome on sudden turning of the head. J Neurol Neurosurg Psychiat 1980, 43:97-101.

[14] 14. Lovshin LL. Carotidynia. Headache 1987, 17:192-195.

[15] 15. Mianzoni GC, Terzano MG, Bono G, Micieli G, Martucci N, Nappi G. Cluster headache: clinical findings in 180 patients. Cephalalgia 1983, 3:21-30.

[16] 16. Massey EW, J. Elongated styliod process (Eagle's syndrome) causing hemicrania. Headache 1979, 19:339-344.

[17] 17. Pfaffenrath V. Cervicogenic headache and its differential diagnosis. In Ferrari MD, Lataste X (eds) : Migraine and Other Headaches. Park Ridge, USA. Parthenon, 1989, p 161-177.

[18] 18. Pfaffenrath V, Dandekar R, Pöllmann W. Cervicogenic headache : the clinical picture, radiological findings and hypotheses on its pathophysiology. Headache 1987, 27:495-499.

[19] 19. Sjaastad O. Chronic paroxismal Hemicrania (CPH). In: Vinken PJ, Bruyn GW, Klawans HLi, Rose FC (eds) : Handbook of Clinical Neurology. Amsterdam: Elsevier 1986, Vol 4 (48), p 257-266.

[20] 20. Sjaastad O, Dale I. Evidence for a new(?) treatable headache entity: a preliminary report. Headache 1974, 14:105-108.

[21] 21. Sjaastad O, Dale I. A new(?) clinical headache entity: chronic paroxysmal hemicrania. Acta Neurol Scand 1976, 54:140-159.

[22] 22. Sjaastad O, Fredriksen TA, Sand T. The localization of the initial pain of attack: a comparison between classic migraine and cervicogenic headache. Functional Neurol 1989, 4:1-6.

[23] 23. Sjaastad O, Fredriksen TA, Sand T, Antonaci F. Unilaterality of headache in classic migraine. Cephalalgia 1989, 9:1-7.

[24] 24. Sjaastad O, Fredriksen TA, Stolt-Nielsen A. Cervicogenic headache, C2 rhizopathy, and occipital neuralgia: a connection? Cephalalgia 1986, 6:189-195.

[25] 25. Sjaastad O, Saunte C, Hovdahl H, Breivik H, Gr0nbaek E. «Cervicogenic» headache: an hypothesis. Cephalalgia 1983, 3:249-256.

[26] 26. Sjaastad O, Saunte C, Salvesen R, Fredriksen TA, Seim A, R0e, OD, Fostad K, Lobben OP, Zhao MJ. Shortlasting, unilateral neuralgiform headache attacks with conjunctival injection, tearing, sweating and rhinorrhea. Cephalalgia 1989, 9:147-156.

[27] 27. Sjaastad O. de Souza Carvalho D, Zhao JM. «Mild» cluster Headache(?). Chephalalgia 1988, 8:121-126.

[28] 28. Sjaastad O, Spierings ELH. Hemicrania continua: another headache absolutely responsive to indomethacin. Cephalalgia 1984, 4:65-70.

[29] 29. Vincent M. Hemicrania paroxística crônica : aspectos clínicos. Rev Bras Neurol 1989, 25:69-75.