Unilateral headaches and their relationship with cervicogenic headache

The concept of headache originating/ starting in the neck is revised and co nsidered in the light of previous descriptions of syndromes and entities an d with reference to the current diagnostic systems for the classification o f headache and other head pain. Cervicogenic headache (CEH), a clinical pic ture recently described by Sjaastad and coworkers and listed in the Interna tional Association for the Study of Pain (IASP) Classification, is analyzed , also faking into consideration ifs diagnostic criteria in terms of sensit ivity and specificity. The problem of a differential diagnosis with migraine, tension headache and other well defined forms of unilateral headaches is discussed with referen ce to a case series of 114 patients who were selected based on their adhere nce to two fundamental criteria: (i) side-locked unilaterality of pain; and (ii) pain starting in the neck and spreading to the fronto-orbital area. B ased on the results, these simple criteria can contribute to a preliminary identification of possible CEH cases that may then undergo a sequence of cl inical and instrumental procedures in order to confirm the diagnosis and, p ossibly, to localize the level(s) of dysfunction in the cervical spine whic h may be the target for therapeutic investigations, whether invasive or non -invasive.