Korean J Anesthesiol.  2011 Feb;60(2):134-137. 10.4097/kjae.2011.60.2.134.

Cervicogenic headache arising from hidden metastasis to cervical lymph node adjacent to the superficial cervical plexus: A case report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea. pain@snu.ac.kr

Abstract

The differential diagnosis of headache is often difficult because the symptom of headache is overlapping. Superficial cervical plexus block is useful in diagnosis and treatment of headache. Headache arising from the neck and radiating to the frontotemporal regions and possibly to the supraorbital region has been defined as cervicogenic headache. A positive response to anesthetic blocks is one of the diagnostic criteria of cervicogenic headache. We experienced a case of headache arising from direct lymph node metastasis of hepatocellular carcinoma adjacent to the superficial cervical plexus during treatment of cervicogenic headache under ultrasonographic guidance. Especially in patients with medical history of cancer, practitioners should consider the possibility of metastasis to cervical lymph nodes and using ultrasonography to evaluate the cervical area prior to the practice.

Keyword

Cervicogenic headache; Diagnostic block; Metastasis; Superficial cervical plexus; Ultrasonography

MeSH Terms

Carcinoma, Hepatocellular
Cervical Plexus
Diagnosis, Differential
Headache
Humans
Lymph Nodes
Neck
Neoplasm Metastasis
Post-Traumatic Headache
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