Interventional Approach to the Diagnosis of Head and Face Pain

  • Vikas AgarwalEmail author
  • Ryan T. Fitzgerald


The differential diagnosis for headache and facial pain is vast. The practitioner must utilize a multidisciplinary approach in order to arrive at a precise diagnosis. As explored in prior chapters, this includes careful history and physical examination as well as imaging. In this chapter, we discuss the use of image-guided interventions to aid in the diagnosis and ultimate management of pain symptomatology.


Facial pain Cervicogenic headache Spontaneous intracranial hypotension Image-guided interventions for pain Nerve block Atlanto-occipital joints Peripheral nerve blocks 


  1. 1.
    Sjaastad O, Saunte C, Hovdahl H, Breivik H, Gronback E. “Cervicogenic” headache. A hypothesis. Cephalalgia. 1983;3:249–56.CrossRefPubMedGoogle Scholar
  2. 2.
    Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. Headache. 1998;38:442–5.CrossRefPubMedGoogle Scholar
  3. 3.
    Ogoke BA. The management of the atlanto-occipital and atlanto-axial joint pain. Pain Physician. 2000;3:289–93.PubMedGoogle Scholar
  4. 4.
    Schievink WI. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. JAMA. 2006;295:2286–96.CrossRefPubMedGoogle Scholar
  5. 5.
    Schievink WI, Meyer FB, Atkinson JL, et al. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension. J Neurosurg. 1996;84:598–605.CrossRefPubMedGoogle Scholar
  6. 6.
    Beards SC, Jackson A, Griffiths AG, et al. Magnetic resonance imaging of extradural blood patches: appearances from 30 min to 18 h. Br J Anaesth. 1993;71:182–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Su CS, Lan MY, Chang YY, et al. Clinical features, neuroimaging and treatment of spontaneous intracranial hypotension and magnetic resonance imaging evidence of blind epidural blood patch. Eur Neurol. 2009;61:301–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Franzini A, Messina G, Nazzi V, et al. Spontaneous intracranial hypotension syndrome: a novel speculative physiopathological hypothesis and a novel patch method in a series of 28 consecutive patients. J Neurosurg. 2010;112:300–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Ferrante E, Arpino I, Citterio A. Is it a rational choice to treat with lumbar epidural blood patch headache caused by spontaneous cervical CSF leak? Cephalgia. 2006;26:1245–6.CrossRefGoogle Scholar
  10. 10.
    Ferrante E, Arpino I, Citterio A, et al. Epidural blood patch in Trendelenburg position premedicated with acetazolamide to treat spontaneous intracranial hypotension. Eur J Neurol. 2010;17:715–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Merskey H, Bogduk N. Classification of chronic pain. Descriptors of chronic pain syndromes and definitions of pain terms. 2nd ed. Seattle: IASP Press; 1994.Google Scholar
  12. 12.
    Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33:629–808.CrossRefGoogle Scholar

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Department of RadiologyUniversity of Arkansas for Medical SciencesLittle RockUSA

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