Clinical Significance
Many medical conditions involve the dura mater. A subdural hematoma occurs when there is an abnormal collection of blood between the dura and the arachnoid, usually as a result of torn bridging veins secondary to head trauma. An epidural hematoma is a collection of blood between the dura and the inner surface of the skull, and is usually due to arterial bleeding.
In 2011, Scali et al., reported a connection of soft tissue from the rectus capitis posterior major to the cervical dura mater. Various clinical manifestations may be linked to this anatomical relationship such as headaches, trigeminal neuralgia and other symptoms that involved the cervical dura (Spine 2011). The rectus capitis posterior minor has a similar attachment as described by Hack et al. in 1995.
The dura-muscular, dura-ligamentous connections in the upper cervical spine and occipital areas may provide anatomic and physiologic answers to the cause of the cervicogenic headache. This proposal would further explain manipulation's efficacy in the treatment of cervicogenic headache.
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