What is it about?
How often does the doctor prescribe magnetic resonance, TC, X-ray examinations, etc. for headaches ? or refers to an ear, nose and throat doctor, neurologist etc.
If there are no injuries or illnesses, anti-inflammatory drugs and vitamins are often given, although the problem may
only be the muscle-tendon tension.
The head and face are particularly innervated parts of the body, but they also contain muscles, tendons, ligaments, connective tissue and joints, just like the shoulder, pelvis, etc.
The pain may well come from skeletal muscle, as with neck pain (cervicalgia), which is closely related to it.
This is not to suggest that all headaches are caused by muscle pain , but if all necessary and doctor-recommended tests have been performed and a negative test result is found, treat the symptoms as if they were musculoskeletal disorders.
Symptoms affecting the skull are: migraines , pain and dizziness .
In the majority of cases, those affected with pain in the face or at the level of the occipital bone (occiput) also have pain in the upper section of the cervical spine because some cranial nerves originate between the occipital bone, first (atlas) and second cervical vertebrae (axis or epistropheus).
There is no association between cervical disc herniation and headache , as there is no intervertebral disc between the first two vertebrae.
A herniated disc below the third cervical vertebra can only cause symptoms along the shoulder and arm because the nerves rooted at this level run to the fingers and not to the head. This condition is also known as Arnold’s neuralgia, which is pain that follows the course of the second cranial nerve: the optic nerve.
A correct diagnosis is essential when it comes to headaches because the patient may also be suffering from another serious condition, such as Arnold Chiari Syndrome.
This congenital pathology is very rare and consists in compression of the occipital nerve (nervus occipitalis), ie the pain originates in the suboccipital region and runs vertically unilaterally or bilaterally up to the eyes.
Arnold Chiari’s syndrome is associated with syringomyelia, myelomeningeocele, and spina bifida , which are protruding meninges, meningeal cysts, or incomplete ossification of the vertebral arch.
These are all very serious pathologies because they affect, damage and reduce the functioning of the central nervous system (brain and spinal cord).
The nerves are the engine of our body, they can absorb all sensations such as heat, pressure, sound, smell, etc., and also generate the necessary muscular contraction for movement, breathing, heartbeat, chewing, etc. The correct functioning of the central nervous system is fundamental for
everyone our activities, especially at the level of the brain and cervical spine , because that is where all the nerves of the human body begin.
What are the causes of Arnold Chiari Syndrome?
The causes of the Arnold-Chiari syndrome (Chiari malformation) is the displacement of some brain structures (cerebellum, hindbrain (medulla oblongata), bridge (pons), tonsils, encephalon and meninges) into the cervical or spinal canal.
This pathology is the result of a malformation of the occipital bone (occiput, os occipitale) at the level of the cranial fossa, which left a wide foramen magnum (large hole in the back leg) during bone formation, through which parts of the brain that are not held in their anatomical seat descend.
Neoplasms or tumors can have the same symptoms as this syndrome because they are pressing on vital nerve structures.
Tension headaches can result from trauma, accidents, surgery, shoulder dislocation, dental work, or malocclusion.
Stress can make symptoms worse, but is usually not the only cause.
The menstrual cycle can also cause the symptoms to appear, but is not solely responsible because there is always an event that has caused the tension or adherence of the connective tissue in the cranial-facial area.
What are the symptoms of Arnold Chiari Syndrome?
Arnold-Chiari syndrome can be asymptomatic or have serious effects, such as dizziness , hearing loss , tinnitus , difficulty chewing, difficulty swallowing (dysphagia), difficulty speaking (dysphonia), and even muscle paralysis and spasticity.
It is important to know if the headache increases with coughing and exercise, as this is characteristic of this condition.
Tension headaches can cause symptoms such as dizziness, headaches, or migraines; Pain and stiffness in the upper neck are less common, as is nausea.
When Arnold-Chiari syndrome is in its early stages and only irritates the cervical nerve roots, it can be mistaken for a musculoskeletal headache, so correct diagnosis is important.
How is Arnold-Chiari Syndrome diagnosed?
The neurologist is the doctor who specializes in this condition; a visit to this specialist is essential because he will assess the relationship between the diagnostic tests (TC, NMR) and the patient’s symptoms. In order to be able to estimate the extent of the displacement of the brain components (pons, hindbrain, cerebellum, etc.), magnetic resonance
is recommended . NMR shows all the structures of the brain, how they relate to each other, and the exact position they occupy. The resonance is also helpful in detecting meningeal cysts, hydrocephalus (water on the brain), or the herniation of meningeal structures (meningocele) that sometimes accompany Arnold-Chiari syndrome.
X-ray examination or TC can give an idea of the degree of development of the cranial fossa.
In Arnold-Chiari syndrome, the suboccipital pressure on the Arnold nerve must induce pain.
If the neurologist cannot diagnose Arnold-Chiari syndrome and the symptoms are neck pain, dizziness, headaches or migraines, a Doppler ultrasound of the carotid arteries can be performed.
An insufficiency of the basilar circulation can cause these complaints.
If all tests are negative, it is a muscle tension headache.
Which therapy for Arnold-Chiari syndrome is most suitable?
Therapy for Arnold-Chiari syndrome is essentially surgical in nature because no drug can displace brain structures from their current position.
Not all neurosurgeons are able to perform the surgery.
Patients often turn to clinics abroad because it is difficult to find the right surgeon in Italy. The procedure consists of suboccipital decompression to relieve pressure on the nerve structures.
If the symptoms can be attributed to muscle tension headaches or Arnold’s neuralgia, manual therapy for the skull/neck area is recommended. Achieving the most effect: fascial manipulation, the McKenzie method , general postural training and osteopathy .
The goal of physiotherapy is to relieve tension, eliminate adherence and retraction of the connective tissue, and regain the correct alignment of the cervical joints of the first two vertebrae.
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