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Cervicogenic headache

Zahid H Bajwa, MD
James C Watson, MD
Section Editor
Jerry W Swanson, MD, MHPE
Deputy Editor
John F Dashe, MD, PhD


Neck pain and cervical muscle tenderness are common and prominent symptoms of primary headache disorders [1]. Conversely, it is plausible that head pain can be referred from bony structures or soft tissues of the neck, a condition called cervicogenic headache [2]. Nevertheless, there has been debate regarding the existence of cervicogenic headache as a distinct clinical disorder, as well as its underlying pathophysiology and source of pain [3-7].

This topic will review the definition, etiology, diagnosis, and treatment of cervicogenic headache.


There is evidence that headache can be caused by referred pain from the upper cervical joints [6].

The anatomic locus for cervicogenic headache is the trigeminocervical nucleus in the upper cervical spinal cord, where sensory nerve fibers in the descending tract of the trigeminal nerve (trigeminal nucleus caudalis) are believed to interact with sensory fibers from the upper cervical roots (figure 1) [8]. This functional intersection of upper cervical and trigeminal sensory pathways is thought to allow the bidirectional transmission of pain signals between the neck and the trigeminal sensory receptive fields of the face and head.

The first three cervical spinal nerves and their rami are the primary peripheral nerve structures that can refer pain to the head (figure 2):

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Literature review current through: Nov 2017. | This topic last updated: May 02, 2016.
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