Cephalalgia : an international journal of headache
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Against a background of increasing demands on limited resources, health economics is gaining an increasing impact on decision making and a basic understanding of the subject is important for all those involved in headache research and service delivery at whatever level. This paper is not intended as a review of the literature in the area of headache economics but discusses some general principles of health economics from the perspective of headache, with a focus on cost of illness studies and economic evaluation.
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Patients with primary headache syndromes often describe a pain distribution, that does not respect the trigeminal innervation of the head. In addition to pain in frontal areas, innervated by the first (ophthalmic) division of the trigeminal nerve, the pain often occurs in occipital parts of the head, innervated by the greater occipital nerve, a branch of the C2 spinal nerve root. Anatomical and neurophysiological studies in animals suggest a convergence of cervical and trigeminal input in the trigeminal nucleus caudalis. ⋯ Three patients suffered pain on the injection site for a few days. Our results indicate that block of the greater occipital nerve is not effective in the treatment of chronic tension type headache. If at all, rather a 'pro-nociceptive' effect was observed.