A Case Report of an Enlarged Suboccipital Nerve with Cutaneous Branch

Lake, Sasha; Iwanaga, Joe; Oskouian, Rod J.; Loukas, Marios; Tubbs, R. Shane

doi:10.7759/cureus.2933

Cited by 2 publications

(5 citation statements)

References 8 publications

(10 reference statements)

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“…The C1 spinal nerve has been noted to have anastomotic connections with both the spinal accessory nerve and hypoglossal nerve [ 3 ]. However, none of these connections is thought to provide cutaneous innervation to the surrounding region.…”

Section: Discussionmentioning

confidence: 99%

“…Fusion of the greater and suboccipital nerves, as seen in the present case, may be a potential consideration in patients with occipital neuralgia who have failed successive treatments, including a diagnostic anesthetic nerve blockade of the nerves innervating the occipital scalp. Interestingly, a dorsal root ganglion of the C1 spinal nerve only about 10% of the time [ 3 ]. During development, sensory neurons of the suboccipital nerve course are found coursing along the spinal accessory nerve.…”

Section: Discussionmentioning

confidence: 99%

“…During development, sensory neurons of the suboccipital nerve course are found coursing along the spinal accessory nerve. Lake et al [ 3 ] classified the variation in the C1 spinal nerve into at least four subtypes. In type I, the dorsal roots of the C1 spinal nerve are absent, and it joins with the spinal accessory nerve.…”

Section: Discussionmentioning

confidence: 99%

“…The dorsal ramus of the C1 spinal nerve, the suboccipital nerve, is located within the suboccipital triangle between the occipital bone and atlas, with the vertebral artery bordering the nerve superiorly where it enters the foramen magnum, and the posterior arch of the atlas bordering the nerve inferiorly [ 1 ]. Although it primarily serves to provide motor innervation to the short suboccipital muscles, the rectus capitis posterior minor, and the semispinalis capitis, it may give off a cutaneous branch supplying the skin overlying the occiput, as reported by Lake et al [ 3 ]. The sensory innervation of this variant branching is not very well understood [ 4 ], but it may be a cause of recalcitrant occipital neuralgia.…”

Section: Introductionmentioning

confidence: 99%

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Fusion of the Greater and Suboccipital Nerves: A Case Report With Application to Patients With Occipital Neuralgia

Wang¹,

Iwanaga²,

Olewnik³

et al. 2022

Cureus

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Atypical presentations of occipital neuralgia might have an anatomical cause. Therefore, a better understanding of variant anatomy in this region can help physicians who treat such patients. During the dissection of the suboccipital region in an 83-year-old at-death male cadaver, an unusual finding was noted between the suboccipital and greater occipital nerves. No branches from this segment of the suboccipital nerve were identified. Therefore, initially, the suboccipital muscles were thought to be innervated not by the suboccipital nerve but rather by branches of the medial (greater occipital nerve) and lateral branches of the C2 dorsal ramus. However, with microdissection, these fibers were found to ascend with the medial branch of the C2 ramus (greater occipital nerve) and to distribute fibers to the rectus capitis minor and major and then continue with the greater occipital nerve to the skin over the occiput. No fibers from the suboccipital nerve traveled to the C2 spinal nerve or its lateral branch. The lateral part of the dorsal ramus of C2 innervated the obliquus capitis superior and obliquus capitis inferior. Additionally, a long slender branch from the lateral branch of the C2 dorsal ramus traveled medially to innervate the skin over the C2 spinous process. This case demonstrates that some fibers in the greater occipital nerve (C2), both cutaneous and motor, can be derived from the suboccipital nerve (C1). This information can help in diagnosing some patients with atypical presentations and can help better target all involved occipital nerves.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Fusion of the Greater and Suboccipital Nerves: A Case Report With Application to Patients With Occipital Neuralgia

Wang¹,

Iwanaga²,

Olewnik³

et al. 2022

Cureus

Self Cite

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“…뒤통수밑 신경은 후두하근육 에 신경 분포를 하여 후방목의 후두부 영역을 담당한다 15) . 때 때로 뒤통수밑신경은 큰뒤통수신경과 연결되는 피부가지를 내 며, 이 해부학적 변이는 후두신경통과 경추성 두통에 관여할 수 있다 16) .…”

Section: ) 풍지혈과 연관된 신경unclassified

Anatomical and Physiological Study on the Therapeutic Effect of GB20 and Brief Case Series

Kang¹,

Kim

Sun

et al. 2021

Journal of Korean Medical Society of Soft Tissue

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The aim of this study is to provide anatomical information of Fengchi (GB20) including applicable needling depth and related physiological effect. Methods: The contents about GB20 were extracted from literature. Then we investigated the clinical effect and needling feature (depth/angle) of GB20, searching on-line databases like 'Oasis', 'RISS', 'DBpia', Pubmed'. Results: According to the classic text, the needling depth of GB20 is 9.3-46.5 mm, When acupuncture is applied at that level, stimulatable anatomical structures were skin, semispinalis capitis, rectus capitis posterior minor, rectus capitis posterior major, greater occipital nerve, third occipital nerve, suboccipital nerve, posterior atlanto-occipital membrane, occipital artery and vein, vertebral artery. Conclusion:In applying GB20 for acupuncture treatments, peripheral disorders are treated by stimulating the semispinalis capitis, the greater occipital nerve, the third occipital nerve, and central disorders are treated by stimulating the rectus capitis posterior minor, the rectus capitis posterior major, the suboccipital nerve.

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A Case Report of an Enlarged Suboccipital Nerve with Cutaneous Branch

Cited by 2 publications

References 8 publications

Fusion of the Greater and Suboccipital Nerves: A Case Report With Application to Patients With Occipital Neuralgia

Fusion of the Greater and Suboccipital Nerves: A Case Report With Application to Patients With Occipital Neuralgia

Anatomical and Physiological Study on the Therapeutic Effect of GB20 and Brief Case Series

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