Cervical migraine called one of the typical manifestations of vertebral artery syndrome, which manifests itself in painful, migraine pain.
Cervical migraine occurs as a result of impaired blood flow in one or both vertebral arteries (right and left).
Disease are synonyms - "vertebral artery syndrome", "posterior cervical sympathetic syndrome", which confuses the terminology.
In the general understanding of this concept comes circulatory disorders in the area of the brain due to a violation of blood flow in one or both vertebral arteries at once.
Circulatory disorders of the vertebral arteries ensure blood flow to 30%, their problems do not lead to catastrophic consequences in the form of strokes, but can give a subjective discomfort with bouts of excruciating headaches, combined with coordination disorders, vision or hearing.
All causes of cervical migraine can be divided into two groups
- nevertebrogennye (non-vertebral problems)
- vertebrogenic (connected with the vertebral lesions).
For nonvertebral reasons include:
- atherosclerotic vascular disease,
- congenital structural abnormalities of the arteries,
- congenital vascular location,
- whiplash (sharp deviation or throwing the head back upon impact or sudden deceleration in the car),
- spasmodic contraction of the neck muscles,
By vertebrogenic causes include spinal problems:
- congenital structural abnormalities of the vertebrae,
- traumatic vertebral anomalies,
- osteochondrosis first and second cervical vertebrae,
- instability of the cervical spine,
- idiopathic (of unknown cause c) Problems.
As a result of all the above reasons, there is irritation of the nerve roots and vertebral arteries that causes a spasm of the muscle cells in their wall and a sharp narrowing of the arteries - starts neck migraine.
Cramps can be constant or occur during head rotation, tilt, or a change in body position. This leads to a decrease in blood flow to the head and the cerebral circulation, to the emergence of headaches.
The process takes place in two stages:
- in the first step occurs or episodic reversible narrowing of blood vessels, which is manifested attacks of headache and associated symptoms.
- a second step of an irreversible narrowing of the vessel walls, is gradually increasing. For displaying heavier and occur more frequently.
Symptoms of cervical migraine
The main symptom of cervical migraines are headaches. Wherein:
- permanent or paroxysmal pain,
- excruciating pain, burning, throbbing, localized in the neck,
- in a fit of pain can give to the eye sockets or nose, in the region of the crown, ears or forehead,
- often unilateral pain, seizures aggravated by change of position of the head and neck,
- head pain when combing or touching,
- head movements are accompanied by itching and burning,
- are dizziness, nausea, vomiting, especially when lifting up the head,
- ringing or noise in the ears, throbbing in time with the heartbeat,
- are disorders of vision and hearing, blurred or fly before his eyes, dvonie,
- You may be feeling a lump in the throat or swallowing difficulties,
- hot flashes or chills,
- in rare cases, pinched an artery could be bouts of unconsciousness during sharp turns of the head.
Characteristic special features that characterize arterial lesions - with pressure on the area of the spinous processes or the back of the head there is a sharp increase in sensitivity of the skin in the neck region.
Diagnostic cervical migraine based on typical complaints of patients, an indication of injury or disease of the cervical spine, as well as samples from the pressing of the projection of additional vertebral arteries with increased symptoms.
In addition, more research is necessary to:
- X-rays of the cervical spine, which reveals a distinct change in the vertebrae and clarifies the causes of the disease,
- ultrasound with dopplerography with the assessment of vertebral arteries blood flow,
- rheoencephalography the definition of cerebral blood flow and permeability concrete arteries,
- CT or MRI neck stratified study of the structure of the vertebrae and the state of the arteries,
- a blood test for lipids and cholesterol.
Treatment of cervical migraine
Treatment and diagnosis of cervical migraine involved neurologists. Applied conservative methods of treatment:
- anti-inflammatory and analgesic agents (meloxicam, nimesulide, Nurofen)
- drugs that improve blood flow and patency of the vertebral arteries (instenon, cinnarizine)
- B vitamins to improve brain power,
- neuroprotective drugs, to protect nerve cells from hypoxia (Cerebrolysin, piracetam or aktovegin)
- metabolite drugs (mildronat)
- antispasmodics to eliminate spasm of arteries and muscles (no-spa, papaverine, Mydocalmum)
- drugs-vegetotoniki (Phenibut)
- protivomigrenoznye drugs (sumatriptan)
- cervical massage, physiotherapy, acupuncture, electrophoresis.
- osteopathic practice,
- in severe cases, surgical stabilization of the cervical vertebrae, the removal of calluses.
In the case of full and timely initiation of treatment the prognosis is favorable, the manifestations of cervical migraine is possible to stop or significantly alleviated. When a running process with organic disorders less favorable prognosis, can only facilitate attacks.