Table 1 Definition of cervicogenic headache [20]

Major criteria

I. Symptoms and signs of neck involvement

Ia. Precipitation of head pain, similar to the usually occurring one:

Ia1) by neck movement and/or sustained, awkward head positioning, and/or:

Ia2) by external pressure over the upper cervical or occipital region on the symptomatic side.

Ib. Restriction of the range of motion (ROM) in the neck.

Ic. Ipsilateral neck, shoulder or arm pain of a rather vague, non-radicular nature, or – occasionally – arm pain of a radicular nature.

II. Confirmatory evidence by diagnostic anaesthetic blockades.

III. Unilaterality of the head pain, without sideshift.

Head pain characteristics

IV. Moderate-severe, non-throbbing pain, usually starting in the neck. Episodes of varying duration, or: fluctuating, continuous pain.

Other characteristics of some importance

V. Only marginal effect or lack of effect of indomethacin. Only marginal effect or lack of effect of ergotamine and sumatriptan. Female sex. Not infrequent occurrence of head or indirect neck trauma by history, usually of more than only medium severity.

Other features of lesser importance

VI. Various attack-related phenomena, only occasionally present, and/or moderately expressed when present: a) nausea, b) phono- and photophobia, c) dizziness, d) ipsilateral “blurred vision”, e) difficulties swallowing, f) ipsilateral oedema, mostly in the periocular area.