Misdiagnosis in Patients with Cervicogenic Headache: The Case Reports of Three Adults

Cervicogenic headache is known to be the most controversial type of headache, because its diagnosis is difficult and usually associated with errors. The signs and symptoms of this headache confuse therapists and cause misdiagnosis; definitive diagnostic criteria and physical tests should be used to accurately diagnose cervicogenic headaches. The current study investigated patients suffering from headaches, then reassessed them using a new diagnosis protocol, and finally provided them with physiotherapy using clinical reasoning strategies.

In this study, three patients who had suffered headaches and tolerated inappropriate treatment due to misdiagnosis were evaluated using diagnostic criteria and physical examination based on the International Headache Society (IHS) criteria. Cervicogenic headache was diagnosed, and accordingly, physiotherapy with a multi-modal intervention approach based on clinical reasoning was administered. The outcome of treatment was assessed using the headache index questionnaire.

Subjects who had suffered, on average, 15 years of chronic, medicine resistance headaches were evaluated. Cervicogenic headache was diagnosed in each of them and physiotherapy was begun. An average improvement rate of 74% was achieved based on the headache index formula. It can be concluded that the use of physical tests in addition to diagnostic criteria will decrease the rate of misdiagnosed cervicogenic headache, and physiotherapy can be the appropriate treatment.