The anatomy of head pain.
Level 5 - mechanism / opinion, no new human data
Narrative review chapter summarizing neuroanatomy and mechanism-based pathways without original empirical data or systematic search methodology
PubMed 38043970 · doi:10.1016/B978-0-12-823356-6.00001-9
What was done
This narrative review chapter synthesized anatomical and clinical literature describing pain-sensitive structures in the head and neck (including the scalp, periosteum, meninges, and cranial blood vessels). It reviewed their peripheral innervation pathways, patterns of referred pain established in awake craniotomy and mechanical/electrical stimulation studies, and central transmission through the trigeminocervical complex to ascending brain structures.
What was found
The abstract reports qualitative neuroanatomical findings and provides no numerical data or effect sizes. Supratentorial dura mater and cranial blood vessels are primarily innervated by the ophthalmic division (V1) of the trigeminal nerve, commonly referring pain to the ipsilateral V1 region and less frequently to V2 or V3. Upper cervical nerves innervate the posterior scalp, while the periauricular and posterior fossa regions share innervation. Nociceptive afferents converge on the trigeminocervical complex before projecting to the brainstem, thalamus, hypothalamus, and cortex.
Why it matters
It outlines the anatomical basis for why intracranial and cranial vascular pathologies frequently produce misleading referred pain patterns in specific trigeminal or cervical dermatomes.
Limits
The abstract describes a narrative textbook chapter without systematic review methods, predefined study selection criteria, or quantitative data synthesis. Specific participant counts, study designs, and experimental parameters from the referenced stimulation studies are not provided.
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