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Cervicogenic headache — SCE Neurology MCQ

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HardHeadacheCervicogenic headacheSCE Neurology

Unilateral occipital pain began after whiplash, is provoked by neck movement and is accompanied by restricted cervical range. Imaging excludes intracranial disease and diagnostic cervical blockade abolishes the pain. What is the diagnosis?

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Correct answer: B — Cervicogenic headache, given the imaging pattern

The best answer is “Cervicogenic headache, given the imaging pattern”. A cervical pain generator with movement provocation and abolition by diagnostic blockade meets cervicogenic headache criteria. “Cluster headache” can be reasonable in another presentation, but it does not account for the defining feature here. “Reversible cerebral vasoconstriction syndrome” can be reasonable in another presentation, but it does not account for the defining feature here. “Trigeminal neuralgia” can be reasonable in another presentation, but it does not account for the defining feature here. “Hypnic headache” can be reasonable in another presentation, but it does not account for the defining feature here.

Reference: ICHD-3 cervicogenic headache: https://ichd-3.org/11-headache-or-facial-pain-attributed-to-disorder-of-the-cranium-neck-eyes-ears-nose-sinuses-teeth-mouth-or-other-facial-or-cervical-structure/11-2-headache-attributed-to-disorder-of-the-neck/11-2-1-cervicogenic-headache/