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Year : 2013  |  Volume : 27  |  Issue : 2  |  Page : 103-107

Lateral atlanto-axial joint block for cervical headache

Interventional Pain Physician, Dr. D. Y. Patil Hospital and Research Center, Nerul, Navi Mumbai, Maharashtra, India

Correspondence Address:
Shantanu P Mallick
B-702, Chawla Plaza, PLST No 14 and 15, Sector-11, CBD Belapur, Navi Mumbai - 400 614, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-5333.119346

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The patient is a 32-year-old car mechanic, having chronic headache for three years affecting the left upper lateral part of the neck, suboccipital region, and scalp (VAS: 8/10), having a history of whiplash injury from a car accident three years ago, with a deep cut injury on the scalp. He was complaining of neck stiffness and pain during all neck movements and a burning pain in the entire left side of the neck and scalp. He was treated, using conservative methods, by Orthopedists, Neurologists, as well as Psychiatrists, and all investigations including computed tomography (CT) of the brain, X-ray cervical spine, and all related blood reports were within normal limits. He was sent to the Pain Clinic for further assessment. Suspecting sympathetic mediated pain on the left side and upper cervical facet pain, he was given a diagnostic Stellate Ganglion Block, a Third Occipital Nerve block, and a fourth cervical medial branch block (MBB), which gave him good relief; by this the visual analog scale (VAS) score reduced to 3/10. Yet, he was complaining of pain on a focal area on the left upper cervical spine corresponding to the C1-2 joint with lateral rotation on the left side. Subsequently it was decided that a diagnostic Atlanto-axial joint block under fluoroscopy would be carried out. This gave him very good relief from the cervicogenic headache.

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