Cervicogenic Headache Mechanism and Diagnosis

Neuroanatomical Basis and Pain Distribution

The International Headache Society recommends understanding that pain typically starts in the neck and spreads to the ipsilateral oculo-fronto-temporal area, reflecting the trigeminal nerve distribution 1
Cervical strain associated with concussion often produces persistent headache that is occipital/suboccipital in location initially, but can refer forward through the convergence of upper cervical nerve fibers with the trigeminal nerve pathways 2

The American Academy of Neurology suggests that the pain is provoked by neck movements, sustained awkward head positions, or palpation of tender points in the cervical spine and suboccipital muscles 2
Clinical examination reveals cervical spine tenderness, paraspinal and suboccipital muscle tenderness, limitation of cervical motion, and pain with cervical movement, according to the American College of Physicians 1, 2
Anesthetic blockade of the affected cervical structures that eliminates the frontal pain confirms the cervical origin, as recommended by the European Federation of Neurological Societies 1