Cervicogenic Headache

Abstract This chapter focuses on cervicogenic headache, a secondary headache disorder in which pain is referred to the head from a source in the cervical spine. It can be challenging to diagnose, in part because neck pain may not be a prominent part of the presentation. One diagnosis which should not be missed is dissection of the vertebral or internal carotid arteries, which can present with neck pain and/or headache. Lesions in the posterior cranial fossa should be eliminated as well. Diagnostic imaging of the cervical spine may be helpful in some cases, although is often not necessary in diagnosing cervicogenic headache. For probable cervicogenic headache, or in circumstances in which diagnostic blocks are not an option, exercises with or without manual therapy seem to be the best options among conservative therapy. Pharmacological treatments are not well established, but neuropathic pain medications, tricyclic antidepressants, and muscle relaxants have been employed.