Epidural corticosteroid blockade in cervicogenic headache

P. Martelletti, F. Di Sabato, M. Granata, D. Alampi*, F. Apponi*, P. Borgonuovo*, C. Reale*, M. Giacovazzo

Department of Clinical Medicine, Headache Centre, and *Institute of Anesthesiology and Reanimation, “La Sapienza” University – Rome (Italy)

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• Anesthesiology

Abstract. – Cervicogenic headache (CGH) is a relatively common form of headache stemming from the neck structures which presents some pathophysiological condition probably linked together with various pain-producing factors. This report presents a series of 9 patients suffering from cervicogenic headache and the results achieved by means of epidural steroid (methylprednisolone 40 mg) injection into the epidural cervical space (C6-C7 or C7-T1) level. The effectiveness of this diagnostic blockade was compared with the results obtained using the same procedure in 6 chronic tension headache (CTH) patients. A sharp decrease in the Numeric Intensity Scale (NIS) and in the Drug Consumption Index (DCI) values were observed after the diagnostic procedure in CGH patients. The short-term (12 hours) and medium-term (4 weeks) marked clinical improvement obtained in CGH patients may increase the number of available diagnostic tools which can be used to identify these underestimated patients population. The long-term effectiveness of this approach in cervicogenic patients is beeing evaluated over time.

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