Prevalence and relative frequency of cervicogenic headache in population- and clinic-based studies: A systematic review and meta-analysis

Background Cervicogenic headache is a rare headache disorder which is garnering increasing clinical and research interest, but whose prevalence and clinical phenotype is surrounded by uncertainty. We found it timely to systematically appraise the current literature on prevalence, relative frequency, and clinical features of cervicogenic headache in population- and clinic-based settings.Methods PubMed and Embase were searched for observational, population- and clinic-based studies published between 1 January 1942 and 3 September 2024 that reported on the prevalence and relative frequency of cervicogenic headache, diagnosed according to the International Classification of Headache Disorders. The titles, abstracts, and full text-articles were screened by two independent investigators. To estimate prevalence and pooled relative frequency of cervicogenic headache across clinic- and population-based studies, random-effects meta-analyses were conducted. The study was pre-registered on PROSPERO (identifier: CRD42024498128) and reported in accordance with the Guidelines for Meta-Analyses of Observational Studies in Epidemiology.Results Three studies met the inclusion criteria from the International Classification of Headache Disorders for diagnosing cervicogenic headache. One was population-based reporting on the prevalence and two were clinic-based reporting on the relative frequency of cervicogenic headache among adult patients who were evaluated for headache in a tertiary care unit. The one population study reported a prevalence of 3.9% with females representing 77.8% of those affected. In the two clinic-based studies, the relative frequency was found to be 3.1% (95%, CI, 2.6-3.8) amongst the adult outpatient population of 3165 patients evaluated for headache, with women representing 80.8% (95%, CI, 71.9-87.4).Conclusions Based on this meta-analysis, data on the prevalence and relative frequency of cervicogenic headache are limited. The scarcity of data stresses the need for further research into cervicogenic headache, the diagnostic criteria, and its current position in the International Classification of Headache Disorders.