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Migraine Headache for 41 years, disappears with a specific neck correction.

Updated: Aug 26, 2023

Signs and Symptoms: Throbbing migraine headache for 41 years.

Type of Trauma: Cannot recall any.

Adjustments: Specific multiple corrections over the cervical spine, guided by the CBCT scan.

Outcome: The migraine headache and the neck stiffness was resolved in 6 visits within 3 months periods.

A female in her mid 50s visited Headache and Neck Clinic for her chronic migraine headache for the last 41 years. Her migraine triggering factors were chocolate and cheese. She also complained a constant neck stiffness. The only management for her migraine was the prescribed migraine tablet. (Commonly known as Rizamelt in NZ)

There was no such traumatic event that she could recall, however since the neurological symptom (migraine), CBCT was ordered to further investigate.

The scan revealed a number of findings that were possibly involved with her migraine headache. The most significant finding was the multiple arcuate foramen at the C1. (Atlas).

There is an incomplete arcuate foramen at the lateral and anterior aspect of the Left C1 TVP, near the superior articular facet of the C1.

There is a complete arcuate foramen at the left C1 posterior arch.

There is an incomplete arcuate foramen at the right C1 posterior arch.

This is an example of the bilateral arcuate foramen at the posterior arch of C1.

The clinical significance of the arcuate foramen at C1 is that it could potentially compress or disturb the vertebral arteries mechanically, and it can affect the function of the vertebral artery. Vertebral arteries are one of the two major blood vessels that transfer the blood to the brain. Therefore if the blood supply is hindered at the place of the vertebral arteries, it can lead to a number of health issues and one of it is a headache. (Also can lead to a back pain, insomnia and more).

Also, her left C2~C4 facet joints are heavily degenerative. They were almost fused.

Presence of the arcuate foramen and the moderate to severe spondylosis (degeneration of the spine) can be quite challenging. The entire purpose of the corrective treatment depends on the joint articulation. Therefore if such calcified or spondylotic structures are discovered, they are the minus factor to the success of the outcome.

Despite all the odds, the patient responded beautifully to the correction. She responded positively only after the third visits. By the 6th visit, not only her neck and the migraine headache disappeared but also the hip pain, which was not reported in the beginning.

This was an excellent case as in despite of such challenging factors, the positive outcome still could be generated. It is impossible to guess (or feel) the presence of the arcuate foramen and severe spondylotic changes. Therefore utilization of the best imaging study, CBCT, and the specific neck correction using the correct instrument was a key to this case.

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