[Nature of headaches in Kimmerle anomaly]

Abstract

Background and purpose: Kimmerle anomaly is an anatomical variant of the first cervical vertebra consisting in the presence of an osseous canal in the place of a sulcus for the vertebral artery. The aim of our work was to determine the nature and frequency of headaches in this anomaly.

Material and methods: A hundred and eight patients, 58 females and 50 males at the age of 18-59 years (M. 36.9 years, SD=9.6) with radiologically verified Kimmerle anomaly were examined. A control group comprised 40 healthy subjects at the similar age range. The diagnosis of headaches was based on the criteria proposed by the IHS. All the patients underwent electrophysiological studies (ENG, EEG and VEP). The results were statistically analyzed using a SPSS/PC+ computer system.

Results: Headaches were reported by 83.3% of patients with Kimmerle anomaly and 15% of controls. The total number of 50% of Kimmerle patients appeared to suffer from tension-type headaches (T-TH) and nearly 25.6% had headaches of a neurovascular nature. Neuralgic headaches were reported by 24.4% of patients. In the control group only T-TH occurred. In 72.2% of patients headaches occurred for the first time before the age of 40 years. The headaches lasted from a few minutes to several days, most frequently from several dozen minutes (43.3% of cases) to a few hours (31.1% of cases). Frequency of headaches in a year was high. Headaches were accompanied by other complaints like dizziness and vertigo, nausea, drop attacks, paresthesia, sight and hearing disturbances and also vegetative symptoms.

Conclusions: In patients with radiologically verified Kimmerle anomaly a complex of clinical signs develops with prevailing headaches (T-TH, neurovascular headaches and neuralgia).