Treatment of Cervicogenic Headache with Cervical Epidural Steroid Injection

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Cervicogenic headache (CGH) is defined as referred pain from various cervical structures innervated by the upper three cervical spinal nerves. Such structures are potential pain generators, and include the atlanto-occipital joint, atlantoaxial joint, C2-3 zygapophysial joint, C2-3 intervertebral disc, cervical myofascial trigger points, as well as the cervical spinal nerves. Various interventional techniques, including cervical epidural steroid injection (CESI), have been proposed to treat this disorder. And while steroids administered by cervical epidural injection have been used in clinical practice to provide anti-inflammatory and analgesic effects that may alleviate pain in patients with CGH, the use of CESI in the diagnosis and treatment of CGH remains controversial. This article describes the neuroanatomy, neurophysiology, and classification of CGH as well as a review of the available literature describing CESI as treatment for this debilitating condition.

Related collections

Most cited references 24

Record: found
Abstract: not found
Article: not found

Practice guidelines for chronic pain management: an updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine.

, (2010)

0 comments Cited 93 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Peripheral neurostimulation for control of intractable occipital neuralgia.

Brad R Weiner, Laura Reed (1999)

Objective. To present a novel approach for treatment of intractable occipital neuralgia using percutaneous peripheral nerve electrostimulation techniques. Methods. Thirteen patients underwent 17 implant procedures for medically refractory occipital neuralgia. A subcutaneous electrode placed transversely at the level of C1 across the base of the occipital nerve trunk produced paresthesias and pain relief covering the regions of occipital nerve pain Results. With follow-up ranging from 1-½ to 6 years, 12 patients continue to report good to excellent response with greater than 50% pain control and requiring little or no additional medications. The 13th patient (first in the series) was subsequently explanted following symptom resolution. Conclusions. In patients with medically intractable occipital neuralgia, peripheral nerve electrostimulation subcutaneously at the level of C1 appears to be a reasonable alternative to more invasive surgical procedures following failure of more conservative therapies.

0 comments Cited 75 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Epidural anatomy examined by cryomicrotome section. Influence of age, vertebral level, and disease.

Q H Hogan (2015)

Cryomicrotome section is a means of anatomic examination with minimal artifact ideally suited to delineating details of tissue relationships in the epidural space. In the past, healthy adult lumbar levels have been studied by this method. This report extends observations to other regions of the vertebral column, other age groups, and some abnormal conditions. The bodies of 26 adults were frozen in toto soon after death, and the bodies of 2 children were frozen after embalming. Unstained anatomy was revealed by sectioning, and the exposed surface was photographed. As compared with the lumbar level, there are diminished epidural contents at the thoracic and cervical levels, and the ligamentum flavum is more frequently discontinuous. A large basivertebral vein with its origin in the anterior epidural space is typical of the lower thoracic and upper lumbar levels. Although the epidural contents are typically divided into compartments, there is incomplete segmentation of the posterior compartments during early childhood and often at thoracic levels in adults. In advanced age with degenerative disc and joint changes, distortion and compression of the epidural space are typical. Variations in epidural anatomy due to vertebral level, age, and disease may alter the ease of epidural entry and passage of catheters and injected solution.

0 comments Cited 27 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Dajie Wang: 215-955-7246 , Dajie.wang@jefferson.edu

Journal

Journal ID (nlm-ta): Curr Pain Headache Rep

Journal ID (iso-abbrev): Curr Pain Headache Rep

Title: Current Pain and Headache Reports

Publisher: Springer US (Boston )

ISSN (Print): 1531-3433

ISSN (Electronic): 1534-3081

Publication date (Electronic): 5 August 2014

Publication date PMC-release: 5 August 2014

Publication date (Print): 2014

Volume: 18

Issue: 9

Electronic Location Identifier: 442

Affiliations

Thomas Jefferson University Hospital, 834 Chestnut Street T150, Philadelphia, PA 19454 USA

Article

Publisher ID: 442

DOI: 10.1007/s11916-014-0442-3

PMC ID: 4148620

PubMed ID: 25091129

SO-VID: a433bafc-984c-460c-9f2e-9cf78fa039bd

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.