Clinical Assessment of Patients with Cervicogenic Headache: A Preliminary Study

Background: The traditional diagnostic criteria of cervicogenic headache (CEH) are mainlysubjective symptoms, thus making its differential diagnosis difficult. Thisstudy aimed to evaluate the diagnostic validity of functional plain radiograms,based on the clinical diagnostic criteria of CEH.Methods: Twenty-two patients with subjectively diagnosed cervicogenic headache,including 7 with a traceable history of neck trauma, and 14 healthy subjectsas controls from rehabilitation clinics were evaluated. All of them receivedplain cervical radiographic examination, including lateral views in the flexion,neutral, and extension positions. The degree of localized kinking wasmeasured to define the level of cervical malalignment. Subjective symptomselicited by a questionnaire were categorized by involved regions.Results: The numbers of localized kinking segments in the lower cervical spine weresignificantly different between the study and control groups (p < 0.05). Thestudy group had more involved segments than the control group. On thequestionnaire, clinical symptoms involving the nasal regions were one of themost common clinical manifestations (36.4%) among cephalic syndrome.Conclusions: For cervicogenic headache, functional plain radiogram may help in clinicaldiagnosis. Abnormal nociceptive afferents due to malalignment may beresponsible for the nasal symptoms.