INTRODUCTION Headache is one of the most common disorders and affects quality of life and work productivity. The cervicogenic headache (CH) is particularly difficult to diagnose because its symptoms overlap with other types of headache. The current clinical diagnostic criteria for CH lack of reliability and validity. The aim of this work is to review the literature in order to identify the symptoms and signs which can be used for diagnosing CH. MATERIALS AND METHODS Between April and September 2011 databases PubMed, PEDro and the Cochrane Library were consulted, using the key words "cervicogenic headache" or "cervical headache", and "diagnosis" or "diagnostic criteria" or "physical impairments”. Studies on reliability and validity of diagnostic criteria for CCG from history and physical exam were included. RESULTS The most valid and reliable symptoms and signs were selected and are presented with the same order of the physical therapist’s assessment: history (exclusion of serious diseases and characteristics of symptoms) and physical examination (postural assessment, exam of the nervous system mechanical sensitivity, Range of Motion-ROM, proprioception, and neuromuscular function). DISCUSSION The characteristics of symptoms detectable by history are essential to orient diagnostic hypothesis, but they are not sufficient to diagnose CH. In addition, no clinical sign if taken in isolation is enough valid and reliable. Reduction of cervical ROM, along with dysfunction in the upper cervical joints and impaired muscle function, if present together, seems the most valid signs. The limits of present study are the small number of the consulted databases and the fair consistence of clinical criteria to diagnose CH. CONCLUSIONS Further research is needed to establish the reliability and validity of these clinical diagnostic criteria, in order to allow a more certain diagnosis of CH.

INTRODUZIONE La cefalea è uno dei disturbi più diffusi ed influisce negativamente sulla qualità di vita e sulla produttività lavorativa. La cefalea cervicogenica (CCG) è particolarmente difficile da diagnosticare, per la sovrapposizione dei sintomi con altri tipi di cefalee. Gli attuali criteri diagnostici clinici per CCG risultano scarsamente validi ed affidabili. Scopo del lavoro è revisionare la letteratura, per identificare i sintomi e i segni dell'esame clinico utili alla diagnosi di CCG. MATERIALI E METODI Tra aprile e settembre 2011 sono state consultate le banche dati PubMed, PEDro e Cochrane Library, utilizzando le parole chiave “cervicogenic headache” o “cervical headache”, e “diagnosis” o “diagnostic criteria” o “physical impairments”. Sono stati inclusi studi sull’affidabilità e validità dei criteri diagnostici nella valutazione del paziente con CCG, in particolare per quanto riguarda l'anamnesi e l'esame fisico. RISULTATI Sono stati selezionati i sintomi e i segni più validi e affidabili e sono stati presentati con un ordine che segue l’iter della valutazione del fisioterapista: esame soggettivo (esclusione di patologie serie e caratteristiche dei sintomi) ed esame fisico (valutazione di postura, meccanosensibilità del sistema nervoso, Range of Motion-ROM, funzione neuromuscolare e propriocezione). DISCUSSIONE Le caratteristiche dei sintomi rilevabili dall'anamnesi sono essenziali per orientare all'ipotesi diagnostica, ma non sono sufficienti per diagnosticare la CCG. Inoltre, nessun segno clinico preso singolarmente è sufficientemente valido ed affidabile. La riduzione del ROM cervicale, insieme alla disfunzione nelle articolazioni cervicali superiori e alla compromissione della funzionalità muscolare, paiono rappresentare, se compresenti, i segni più validi. Limiti dello studio possono essere identificati nel numero delle banche dati consultate e nella insufficiente consistenza dei criteri clinici per la diagnosi di CCG. CONCLUSIONI In futuro saranno necessarie ulteriori ricerche per stabilire l'affidabilità e la validità di tali criteri diagnostici clinici, allo scopo di consentire una più sicura diagnosi di CCG.

Clinical diagnostic criteria for cervicogenic headache. A narrative review of the literature. Criteri diagnostici clinici per la cefalea cervicogenica. Una revisione narrativa della letteratura.

VANTI, CARLA
2013

Abstract

INTRODUCTION Headache is one of the most common disorders and affects quality of life and work productivity. The cervicogenic headache (CH) is particularly difficult to diagnose because its symptoms overlap with other types of headache. The current clinical diagnostic criteria for CH lack of reliability and validity. The aim of this work is to review the literature in order to identify the symptoms and signs which can be used for diagnosing CH. MATERIALS AND METHODS Between April and September 2011 databases PubMed, PEDro and the Cochrane Library were consulted, using the key words "cervicogenic headache" or "cervical headache", and "diagnosis" or "diagnostic criteria" or "physical impairments”. Studies on reliability and validity of diagnostic criteria for CCG from history and physical exam were included. RESULTS The most valid and reliable symptoms and signs were selected and are presented with the same order of the physical therapist’s assessment: history (exclusion of serious diseases and characteristics of symptoms) and physical examination (postural assessment, exam of the nervous system mechanical sensitivity, Range of Motion-ROM, proprioception, and neuromuscular function). DISCUSSION The characteristics of symptoms detectable by history are essential to orient diagnostic hypothesis, but they are not sufficient to diagnose CH. In addition, no clinical sign if taken in isolation is enough valid and reliable. Reduction of cervical ROM, along with dysfunction in the upper cervical joints and impaired muscle function, if present together, seems the most valid signs. The limits of present study are the small number of the consulted databases and the fair consistence of clinical criteria to diagnose CH. CONCLUSIONS Further research is needed to establish the reliability and validity of these clinical diagnostic criteria, in order to allow a more certain diagnosis of CH.
2013
VANTI, CARLA
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/623688
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