11.2.1 Cervicogenic headache

Identification: Female patient, 45 years old, presenting with unilateral right-sided pain in the occipital region, radiating to the forehead and orbit.

History of Present Illness:

Continuous, moderate to severe, non-pulsatile pain for 6 months.

Worsens with cervical movements (especially rotation and extension) and prolonged posture.

Associated with cervical stiffness and limitation of range of motion.

No reports of nausea, vomiting, photophobia, or phonophobia.

Physical/Neurological Examination:

Sensitivity: Painful points in the right suboccipital region (occipital muscles and C1-C2).

Palpation: Increased pain on palpation of the ipsilateral sternocleidomastoid and upper trapezius muscles.

Cervical Movement: Restriction and reproduction of pain with passive movement of the cervical spine.

Neurological Examination: No motor, sensory deficits, or altered reflexes.

Complementary Exams:

Cervical Spine MRI: Disc degeneration at C5-C6 and C6-C7, without nerve compression or myelopathy.

Diagnostic Anesthetic Block: Infiltration of the right greater occipital nerve resulted in significant pain relief (confirmation criterion).