孟天予,王宝军,薛慧

• 1:内蒙古医科大学
• 2:包头市中心医院

摘要(Abstract)：

颈源性头痛(CEH)是一种常见的慢性头痛,其发病率近年来呈上升趋势,且趋于年轻化,对患者的生活质量造成严重影响。目前其诊断主要依靠主观症状,缺乏特异的生物学标记物、实验室检查及影像学检查。学界较为统一的观点认为C_1～C_3脊神经的外周神经结构异常是CEH的重要解剖学基础,且椎管内、外的病理改变均可成为CEH的潜在病因。彩色多普勒超声(US)是一种具有使用便捷、费用低廉、无创、无射线损害且可重复实时动态成像等独特优点的检查手段,近年来迅速发展的高频超声,已可清晰显示出颈部肌肉、神经、关节囊、血管等相关组织的空间关系以及走形变化,同时可通过信号变化判断病变,并行定量分析,其上述特性均可为诊断CEH提供依据,并可以评价预后及疗效。本文通过回顾相关文献,对彩色多普勒在CEH诊疗中的应用进展作一综述。

关键词(KeyWords)： 颈源性头痛;超声检查;多普勒超声;辅助检查

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 孟天予,王宝军,薛慧

参考文献(References)：

• [1] SJAASTAD O,SAUNTE C,HOVDAHL H,et al."Cervicogenic" headache.An hypothesis[J].Cephalalgia,1983,3(4):249-256.
• [2] BOGDUK N,GOVIND J.Cervicogenic headache:an assessment of the evidence on clinical diagnosis,invasive tests,and treatment[J].Lancet Neurol,2009,8(10):959-968.
• [3] 张一楠,谭戈,周泽芳.颈源性头痛ICHD诊断标准的研究进展[J].中国实用神经疾病杂志,2019,22(23):2665-2668.
• [4] No authors listed.Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders,3rd edition[J].Cephalalgia,2018,38(1):150-151.
• [5] VINCENT M B.Cervicogenic headache:the neck is a generator:con[J].Headache,2010,50(4):706-709.
• [6] BECKER W J.Cervicogenic headache:evidence that the neck is a pain generator[J].Headache,2010,50(4):699-705.
• [7] BOGDUK N,BARTSCH T.Headaches of cervical origin:focus on anatomy and physiology[M].London:BC Decker,2005:369.
• [8] BOGDUK N,BARTSCH T.Cervicogenic headache[M].New York:Oxford University Press,2008:551.
• [9] DWYER A,APRILL C,BOGDUK N.Cervical zygapophyseal joint pain patterns.I:A study in normal volunteers[J].Spine,1990,15(6):453-457.
• [10] KNACKSTEDT H,BANSEVICIUS D,AASETH K,et al..Cervicogenic headache in the general population:The Akershus study of chronic headache.[J].Cephalalgia,2010,30(12):1468-1476.
• [11] KANG T,LANNI S,NAM J,et al.The evolution of ultrasound in rheumatology[J].Ther Adv Musculoskelet Dis,2012,4(6):399-411.
• [12] FORNAGEB D.Peripheral nerves of the extremities:imaging with US[J].Radiology,1988,167(1):179-182.
• [13] WATANABE T,ITO H,SEKINE A,et al.Sonographic evaluation of the peripheral nerve in diabetic patients:the relationship between nerve conduction studies,echo intensity,and cross-sectional area[J].J Ultrasound Med,2010,29(5):697-708.
• [14] TAGLIAFICO A,TAGLIAFICO G,MARTINOLI C.Nerve density:a new parameter to evaluate peripheral nerve pathology on ultrasound.Preliminary study[J].Ultrasound Med Biol,2010,36(10):1588-1593.
• [15] BOO M J,VISSER L H.Quantitative assessment of nerve echogenicity:comparison of methods for evaluating nerve echogenicity in ulnar neuropathy at the elbow[J].Clin Neurophysiol,2012,123(7):1446-1453.
• [16] LOUKAS M,EL-SEDFY A,TUBBS R S,et al.Identification of greater occipital nerve landmarks for the treatment of occipital neuralgia[J].Folia morphologica,2006,65(4):337-342.
• [17] DUCIC I,MORIARTY M,AL-ATTAR A.Anatomical variations of the occipital nerves:implications for the treatment of chronic headaches[J].Plastic Reconstr Surg,2009,123(3):859-863.
• [18] CHO J C,HAUN D W,KETTNER N W.Sonographic Evaluation of the Greater Occipital Nerve in Unilateral Occipital Neuralgia[J].J Ultrasound Med,2012,31(1):37-42.
• [19] WANG L,DAS S,YANG H.DTI of greatoccipital nerve neuropathy:an initial study in patients with cervicogenic headache[J].Clin Radiol,2019,74(11):891-899.
• [20] ANTONACI F,SJAASTAD O.Cervicogenic headache:a real headache[J].Curr Neurol Neurosci Rep,2011,11(2):149-155.
• [21] LAURETTI G R,CORRêA S W R O,MATTOS A L.Efficacy of the Greater Occipital Nerve Block for Cervicogenic Headache:Comparing Classical and Subcompartmental Techniques[J].Pain Pract,2015,15(7):654-661.
• [22] FINLAYSON R J,ETHERIDGE J B,VIEIRA L,et al.A randomized comparison between ultrasound-and fluoroscopy-guided third occipital nerve block[J].Reg Anesth Pain Med,2013,38(3):212-217.
• [23] WALD J T,MAUS T P,GESKE J R,et al.Safety and efficacy of CT-guided transforaminal cervical epidural steroid injections using a posteriorapproach[J].J Neuroradiol,2012,33(3):415-419.
• [24] PALAMAR D,ULUDUZ D,SAIP S,et al.Ultrasound-guided greater occipital nerve block:an efficient technique in chronic refractory migraine without aura?[J].Pain Physician,2015,18(2):153-162.
• [25] RYU J H,SHIM J H,YEOM J H,et al.Ultrasound-guided greater occipital nerve block for patients with occipital headache and short term follow up[J].Korean J Anesthesiol 2011,61(1):50-54.
• [26] VANDERHOEK M D,HOANGH T,GOFF B.Ultrasound-guided greater occipital nerve blocks and pulsed radiofrequency ablation for diagnosis and treatment of occipital neuralgia[J].Anesth Pain Med,2013,3(2):256-259.
• [27] PINGREE M J,SOLE J S,O′BRIEN T G,et al.Clinical Efficacy of an Ultrasound-Guided Greater Occipital Nerve Block at the Level of C2[J].RegAnesthPain Med,2017,42(1):99-104.
• [28] NAVANI A,MAHAJAN G,KREI S P,et al.A case of pulsed radiofrequency lesioning for occipital neuralgia[J].Pain Med,2006,7(5):453-456.
• [29] RYU J H,SHIM J H,YEOM J H,et al.Ultrasound-guided greater occipital nerve block with botulinum toxin for patients with chronic headache in the occipital area:a randomized controlled trial[J].Korean J Anesthesiol,2019,72(5):479-485.
• [30] ZITOG,JULLG,STORY I.Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache[J].Man Ther,2006,11(2):118-129.
• [31] HALL T,BRIFFA K,HOPPER D.Clinical evaluation of cervicogenic headache:a clinical perspective[J].J Man Manip Ther,2008,16(2):73-80.
• [32] HALL T,ROBINSON K.The flexion-rotation test and active cervical mobility--a comparative measurement study in cervicogenic headache[J].Ma Ther,2004,9(4):197-202.
• [33] JULL G,AMIRI M,BULLOCK-SAXTON J,et al.CervicalMusculoskeletal Impairment in Frequent Intermittent Headache.Part 1:Subjects With Single Headaches[J].Cephalalgia,2016,27(7):793-802.
• [34] CHEN Y,CHAI H,WANG C,et al.Asymmetric Thickness of Oblique Capitis Inferior and Cervical Kinesthesia in PatientsWith Unilateral Cervicogenic Headache[J].J Manipulative Physiol Ther,2018,41(8):680-690.
• [35] JULL G,AMIRI M,BULLOCK-SAXTO N J,et al.Cervical musculoskeletal impairment in frequent intermittent headache.Part 1:Subjects with single headaches[J].Cephalalgia,2007,27(7):793-802.
• [36] ABASPOUR O,JAVANSHIR K,AMIRI M,et al.Relationship between cross sectional area of Longus Colli muscle and pain laterality in patients with cervicogenic headache[J].J Back Musculoskelet Rehabil,2015,28(2):393-399.
• [37] ABASPOUR O,AKBARI M,REZASOLTANI A,et al.Relationship between thickness of deep neck muscles synergy and painful side in patients with cervicogenic headache[J].Cranio,2019:1-7.
• [38] OLIVIER B,PRAMOD A,MALEKA D.Trigger Point Sensitivity Is a Differentiating Factor between Cervicogenic and Non-Cervicogenic Headaches:A Cross-Sectional,Descriptive Study[J].Physiother Can,2018,70(4):323-329.
• [39] BODES-PARDO G,PECOS-MARTíN D,GALLEGO-IZQUIERDO T,et al.Manual Treatment for Cervicogenic Headache and Active Trigger Point in theSternocleidomastoid Muscle:A Pilot Randomized Clinical Trial[J].J Manipulative Physiol Ther,2013,36(7):403-411.
• [40] SIKDAR S,SHAHJ P,GEBREAB T,et al.Novel applications of ultrasound technology to visualize and characterize myofascial trigger points and surrounding soft tissue[J].Arch Phys Med Rehabil,2009,90(11):1829-1838.
• [41] JAFARI M,BAHRPEYMA F,TOGHA M.Effect of ischemic compression for cervicogenic headache and elastic behavior of active trigger point in the sternocleidomastoid muscle using ultrasoundimaging[J].J Bodyw Mov Ther,2017,21(4):933-939.
• [42] TOGHA M,BAHRPEYMA F,JAFARI M,et al.A sonographic comparison of the effect of dry needling and ischemic compression on the active trigger point of the sternocleidomastoid muscle associated with cervicogenic headache:A randomized trial[J].J Back Musculoskelet Rehabil,2019 Nov 21.
• [43] MINGELS S,DANKAERTS W,GRANITZER M.Preclinical Signs of a Temporomandibular Disorder in Female Patients With Episodic Cervicogenic Headache VersusAsymptomatic Controls:A Cross-Sectional Study[J].PMR,2019,11(12):1287-1295.
• [44] VON PIEKARTZ H,LüDTKE K.Effect of treatment of temporomandibular disorders (TMD) in patients with cervicogenic headache:a single-blind,randomized controlled study[J].Cranio,2011,29(1):43-56.
• [45] KUNDU H,BASAVARAJ P,KOTE S,et al.Assessment of TMJ Disorders Using Ultrasonography as a Diagnostic Tool:A Review[J].J Clin Diagn Res,2013,7(12):3116-3120.
• [46] KIRKHUS E,GUNDERSON R B,SMITH H,et al.Temporomandibular joint involvement in childhood arthritis:comparison of ultrasonography-assessed capsular width and MRI-assessed synovitis[J].Dento Maxillofac Radiol,2016,45(8):20160195.
• [47] AZLA? PEKINCE K,?A?LAYAN F,PEKINCE A.The efficacy and limitations of USI for diagnosing TMJ internal derangements[J].Oral Radiol,2020,36(1):32-39.