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The main objective of the present investigation was to search for cervicogenic headache (CEH) after whiplash injury. Whiplash patients (n= 587), were followed for a year after their emergency service consultation. A total of 222 patients with headache after 1 month went through interview and examinations at 6 weeks, 6 months and 1 year. All included persons received a questionnaire after 1 year. De novo CEH seemed to be present in 8% at 6 weeks and in 3% at 1 year. Previous car accidents, pre-existing headache and neck pain were more frequent in chronic CEH individuals than in those in the cohort without CEH. Range of motion in the neck was reduced in 65% of chronic CEH individuals hours after the accident, compared with 41% in the cohort. Cybex inclinometer, at 6 weeks and 1 year, demonstrated reduced extension in the neck. CEH seems to be present after whiplash injury, particularly in the early phase. It seems similar to, but probably not identical to, non-whiplash CEH.

Cervicogenic headache (CEH) with pain radiating from the neck to the forehead is a common finding after whiplash injury. In most whiplash studies, the whiplash headaches are not defined. Post-whiplash CEH typically is a moderate headache with a benign, but often prolonged course. It probably is unilateral and bilateral. Reduced neck mobility does not seem to be as common after whiplash as in chronic CEH in general. Post-whiplash CEH is accompanied by great disability and high use of medication. Although the natural course seems favorable for unilateral CEH during the first postinjury years, some patients will need specific treatment for their headaches. There is a lack of controlled studies to guide practitioners to choose investigations and treatment for chronic CEH.

IntroductionThe term cervicogenic headache (CEH) refers to a head pain condition that has its origin in the neck. Such ideasheadache of nuchal origin -must have occupied the minds of men for centuries. A more systematic search for such headaches seems to have been made only from the early stages of last century [1]. The reason for the lack of breakthrough of such ideas was probably the vague, indistinct descriptions of the headache in the original works, and confusion with other headaches, like migraine without aura and tension-type headache, none of which were properly defined at that time. Cardinal symptoms, beside the headache, were supposed to be dizziness, visual disturbances and tinnitus -the attacks in part lasting two to three hours. This constellation of symptoms has little to do with the CEH picture that we know today. Clinicians who conscientiously were searching for cases of headache stemming from the neck on those premises could be easily and widely misled. An overview of the early description could be the basis for a better understanding of the current terminology as far as CEH is concerned. J Headache Pain (2005) 6:462-466 DOI 10.1007 Concepts leading to the definition of the term cervicogenic headache: a historical overview