The Role of the Cervical Spine in Sports Concussion and Post Traumatic Headache: Physiological and Anatomical Correlates

Sports related concussion has quickly become the most widely publicized neurological disorder with estimates ranging from 1.6 to 3.8 million affected individuals annually. The cervical spine plays a major role in concussion biomechanics. The cervical spine has also been implicated as playing a major role in triggering and maintaining migraine headache 1, 2 Patients with migraine especially chronic migraine, often experience neck pain as part of their symptomatology. Post traumatic headache (which in most individuals meets the International Headache Society (IHS) criteria for migraine) is the most common symptom of sports related concussion with a prevalence approaching 90%. 3 In addition, both concussion and migraine share a common underlying physiological process i.e. the hyper-excitable brain. Despite their similarities and common physiological entity i.e. the cervical spine, there are no published reports linking the cervical spine with the underlying anatomic, physiological and biomechanical processes of sports concussion and post traumatic migraine headache.