Unterscheiden sich die pathobiologischen Mechanismen von zervikogenem Kopfschmerz von jenen der Migräne und Spannungskopfschmerz?

Zusammenfassung

Zervikogene Kopfschmerzen werden als durch Dysfunktionen in der hochzervikalen Wirbelsäule verursachte Kopfschmerzen beschrieben. Einige medizinische Disziplinen betrachten diese Kopfschmerzform aufgrund unzureichender pathobiologischer Erklärungsmodelle kritisch oder halten sie teilweise sogar für nicht existent, während sie die neuromuskeloskeletale Therapie als eigenständige Entität anerkennt.

Anhand einer systematischen Literaturrecherche reflektiert die vorliegende Arbeit sowohl die gängigen Diagnosekriterien als auch die Unterschiede und Überlappungen von zervikogenem Kopfschmerz zu Migräne ohne Aura bzw. Spannungskopfschmerz unter Einbeziehung des tatsächlich vorherrschenden pathobiologischen Mechanismus.

Mit der Überlegung peripherer und zentraler Sensibilisierungsprozesse zeigten sich deutliche Überschneidungen im Bereich der pathobiologischen Mechanismen von zervikogenem Kopfschmerz, Migräne ohne Aura und Spannungskopfschmerz. Daher sollten die Diagnosekriterien um diesen Hintergrund erweitert bzw. angepasst werden. Aus manualtherapeutischer Sicht ergibt sich die mögliche Behandlung dieser Kopfschmerzarten nach eingehender struktureller Untersuchung und Screening angrenzender Faktoren unter Beachtung der zugrundeliegenden Schmerzmechanismen.

Abstract

Cervicogenic headache is described as having its source in dysfunction of the upper cervical spine. Due to insufficient pathobiological explanatory models several medical disciplines consider this type of headache critically or even consider it as non-existent, whereas neuromuscular therapy recognises it as an independent entity.

Using a systematic literature review this article examines the established diagnostic criteria and the differences and overlapping of criteria for cervicogenic headache with migraine without aura and tension headache whilst taking the prevalent pathobiological mechanisms into account.

On considering peripheral and central sensitisation processes distinct overlapping in the area of pathobiological mechanisms of cervicogenic headache, migraine without aura and tension headache were revealed. Diagnostic criteria should therefore be extended and adapted to take this into consideration. From the manual therapeutic point of view selection of possible treatment for these types of headache results from accurate structural examination and screening of related factors with respect to the underlying pain mechanisms.

Schlüsselwörter

zervikogener Kopfschmerz - Diagnosekriterien - Migräne ohne Aura Spannungskopfschmerz - zentrale Sensibilisierung

Keywords

cervicogenic headache - diagnostic criteria - migraine without aura tension type headache - central sensitisation

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