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Test diagnostici per la cefalea cervicogenica

La cefalea cervicogenica (CGH) è una patologia comune descritta per la prima volta oltre trent’anni fa nel 1983 e, come già descritto in articolo precedente (clicca qui), essa è classificata tra le cefalee secondarie, in questo caso a disfunzioni muscolo-scheletriche nella regione cervicale, in particolare ai primi segmenti del rachide cervicale. La CGH costituisce circa il 15-20% di tutti le cefalee croniche e ricorrenti. Nonostante il consenso riguardo gli aspetti clinici, non vi sono studi che hanno riassunto la specificità e l’accuratezza diagnostica dei test per l’esame clinico usati per diagnosticare la CGH. Il problema più grande di questa patologia è differenziazione con altre patologie sovrapponibile ad essa, il che porta ad una incorretta diagnosi in approssimativamente il 50% dei casi, oltre che l’esclusione di eventuali red flags. Per questo motivo è stato suggerito che la diagnosi differenziale della cefalea deve consistere in un solido esame soggettivo e in un dettagliato esame del rachide cervicale, considerando soprattutto il fatto che la CGH è la classificazione di cefalea che più spesso risponde in modo positivo nel lungo termine al trattamento fisioterapico.

A questo proposito diversi studi hanno investigato la specificità di vari test diagnostici per questa problematica. I test più comunemente usati per accuratezza diagnostica includono il test di flesso-rotazione cervicale (CFRT), i movimenti accessori passivi (PAIVMs), il gruppo di ROM cervicali, l’esame manuale del tratto cervicale e il test di flessione cranio-cervicale.

Il CFRT è un test molto specifico e sensibile dove si valuta la comparsa della sintomatologia oltre che la perdita di movimento. Il test è considerato molto valido per le vertebre C1-C2.

Fonte: guidagalatticaperfisioterapisti.wordpress.com

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