![]() ![]() The anatomic locus for CEH is the trigeminocervical nucleus in the upper cervical spinal cord, the convergence between the upper cervical nociceptive afferents and the trigeminal nociceptive afferents in the trigeminocervical complex. The diagnostic criteria recommended by the International Classification of Headache Disorders 3 rd edition are as follows: (1) Any headache fulfilling criterion (3) (2) Clinical, laboratory and/or imaging evidence of a disorder or lesion within the cervical spine or soft tissues of the neck that can cause headache (3) Evidence of causation demonstrated by at least two of the following findings: (a) Headache developed in temporal relation to the onset of cervical disorder or appearance of the lesion (b) Headache that significantly improved or resolved along with an improvement in or the resolution of cervical disorder or lesion (c) The cervical range of motion is reduced, and the headache is significantly aggravated by provocative maneuvers and (d) Headache disappears after diagnostic block to the suspected cervical spine structure or its supply nerve and (4) Headache that is not better accounted for by another International Classification of Headache Disorders-3 diagnosis. In accordance with the current International Headache Society criteria, the CASP expert group defines CEH as any headache caused by a disorder of the cervical spine or its components, such as bone, disc and/or soft tissue elements that is usually but not invariably accompanied by neck pain. The two conflicting viewpoints when defining CEH are as follows: (1) Relying on the clinical features, CEH is said to be characterized by unilateral head pain of fluctuating intensity that is increased by movement of the head, and the pain radiates from the occipital to the frontal regions and (2) Relying on establishing the diagnosis involves demonstrating a cervical source of head pain and confirming the diagnosis by using anesthetic blocks that pinpoint the sources of pain in the upper cervical joints. We hope this guideline provides direction for clinicians and patients making treatment decisions for the management of CEH. Twenty-four recommendations were finally developed through expert consensus voting for evidence quality and recommendation strength. A systematic review of the literature was performed, and evidence supporting the benefits and harms for the management of CEH was summarized. A group of multidisciplinary Chinese Association for the Study of Pain experts identified the clinically relevant topics in CEH. The Chinese Association for the Study of Pain asked an expert panel to develop recommendations for a series of questions that are essential for daily clinical management of patients with CEH. Therefore, there is a great need for comprehensive evidence-based Chinese experts’ recommendations for the management of CEH. ![]() ![]() In China, CEH patients are managed by many different specialties, and the treatment plans remain controversial. Cervicogenic headache (CEH) has been recognized as a unique category of headache that can be difficult to diagnose and treat. ![]()
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