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Case Reports
. 2018 Oct-Dec;13(4):1229-1232.
doi: 10.4103/ajns.AJNS_197_17.

Chronic Unilateral Temporo-Occipital Headache Attributed to Unilateral C3 Radiculopathy

Hak-Cheol Ko  1 , Byung-Chul Son  1   2
Affiliations
Case Reports

Chronic Unilateral Temporo-Occipital Headache Attributed to Unilateral C3 Radiculopathy

Hak-Cheol Ko et al. Asian J Neurosurg. 2018 Oct-Dec.

Abstract

Although C1-C3 upper cervical radiculopathy can cause a headache, most case reports are occipital neuralgia (ON), not headache. Here, we report a unique case of chronic temporo-occipital headache due to C3 radiculopathy. A 62-year-old male presented with a chronic left-sided temporo-occipital headache with duration of 4 years. The headache was aching and pressure like in nature. It had a typical radiating pattern on every occasion. It started in the posterior temporal area above the ear. It then extended to retroauricular area, then suboccipital area, and lateral neck. No hypesthesia, allodynia, or limitation in neck motion was noted. Myelographic computed tomography revealed a left-sided C2/C3 foraminal stenosis. Subsequent foraminotomy and decompression of the left C3 completely alleviated the chronic left-sided temporo-occipital headache. Unilateral C3 radiculopathy can cause chronic temporo-occipital headache besides ON. The present case might be a typical example of "headache attributed to upper cervical radiculopathy" (A11.2.4) rather than cervicogenic headache according to the International Classification of Headache Disorders, 3rd edition (beta version).

Keywords: C3 radiculopathy; greater occipital nerve; headache; lesser occipital nerve; occipital neuralgia.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
A schematic diagram demonstrating the distribution and spreading of the temporo-occipital headache owing to C3 radiculopathy. An aching pain gradually developed in his left posterior temporal area over the ear (1) and spread to retroauricular occipital area (2). It then extended to suboccipital area and lateral neck (3)
Figure 2
Figure 2
A sagittal oblique image of myelographic computed tomography of the cervical spine showing narrowing of the left C2/C3 foraminal stenosis and small osteophyte causing chronic C3 radiculopathy
Figure 3
Figure 3
An intraoperative photograph showing the decompressed C3 nerve root (arrow) with foraminotomy. An arrowhead indicates the cord dura
Figure 4
Figure 4
A postoperative, sagittal oblique image of computed tomography of the cervical spine showing widening of the left C2/C3 foramen (arrow
See this image and copyright information in PMC

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