Pathophysiology and Diagnosis of Nerve Compression Headache

Compression of extracranial nerves may result in chronic, medically refractory headaches and neck pain. Recently discovered anatomic connections between the extracranial space and intracranial trigeminal pathways may provide a conduit by which the extracranial pathology of the sensory nerves of the face, scalp, and neck may lead to headaches that are often accompanied by migraine-like features of photophobia and nausea. Nerve compression headaches have a unique presentation that follows from the mechanism and pathophysiology of nerve compression, and the diagnosis may be made on the basis of careful history and the physical examination.