Greater Occipital Nerve Neuralgia Caused by Pathological Arterial Contact: Treatment by Surgical Decompression

Cornely, C.; Fischer, Marius; Ingianni, G.; Isenmann, Stefan

doi:10.1111/j.1526-4610.2010.01802.x

Cited by 30 publications

(40 citation statements)

References 12 publications

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“…The etiology in the present case is indeed the same as that reported by Cornely et al [36], in which the GON was entrapped by pathological contact with the occipital artery. In their report, a 66-year-old woman with severe right-sided occipital neuralgia showed a severe tenderness over the trunk of the right GON with a strong pulsation of the occipital artery branch.…”

Section: Discussionsupporting

confidence: 89%

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Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve

Son

Choi

2017

Case Reports in Neurological Medicine

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Here we report a unique case of chronic occipital neuralgia caused by pathological vascular contact of the left greater occipital nerve. After 12 months of left-sided, unremitting occipital neuralgia, a hypesthesia and facial pain developed in the left hemiface. The decompression of the left greater occipital nerve from pathological contacts with the occipital artery resulted in immediate relief for hemifacial sensory change and facial pain, as well as chronic occipital neuralgia. Although referral of pain from the stimulation of occipital and cervical structures innervated by upper cervical nerves to the frontal head of V1 trigeminal distribution has been reported, the development of hemifacial sensory change associated with referred trigeminal pain from chronic occipital neuralgia is extremely rare. Chronic continuous and strong afferent input of occipital neuralgia caused by pathological vascular contact with the greater occipital nerve seemed to be associated with sensitization and hypersensitivity of the second-order neurons in the trigeminocervical complex, a population of neurons in the C2 dorsal horn characterized by receiving convergent input from dural and cervical structures.

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Section: Discussionsupporting

confidence: 89%

“…While occipital neuralgia is mostly considered idiopathic, specific causes of occipital neuralgia should be excluded from individual cases [23–36]. The etiology in the present case is indeed the same as that reported by Cornely et al [36], in which the GON was entrapped by pathological contact with the occipital artery.…”

Section: Discussionsupporting

confidence: 80%

Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve

Son

Choi

2017

Case Reports in Neurological Medicine

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“…Greater occipital nerve neuralgia is paroxysmal, lancinating pain located to the occipital skin region supplied by the greater occipital nerve, sometimes accompanied by dull, continuous pain (1,4). It is a rare cause of severe cranial headache, and may be refractory to medical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Greater occipital nerve neuralgia is a rare cause of severe cranial headache, and may be refractory to medical treatment (1,7). Most patients present first at the neurological outpatient department, and are treated by medical methods, including analgesics and sedation.…”

Section: Introductionmentioning

confidence: 99%

Micro-surgical decompression for greater occipital neuralgia

Ma²,

Zou³

et al. 2011

Turkish Neurosurgery

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AIM:To evaluate the clinical effect of micro-surgical decompression of greater occipital nerve for greater occipital neuralgia (GON). MATeRIAL and MeTHods:76 patients underwent surgical decompression of the great occipital nerve. A nerve block was tested before operation. The headache rapidly resolved after infiltration of 1% Lidocaine near the tender area of the nerve trunk.ResULTs: 89 procedures were performed for 76 patients. The mean follow up duration was 20 months (range 7-52 months). The headache symptoms of 68 (89.5%) patients were completely resolved, and another 5 (6.6%) patients were significantly relieved without the need for any further medical treatment. Three (3.9%) patients experienced recurrence of the disorder. All patients experienced hypoesthesia of the innervated area of the great occipital nerve. They recovered gradually within 1 to 6 months after surgery.CoNCLUsIoN: Micro-surgical decompression of the greater occipital nerve is a safe and effective method for greater occipital neuralgia. We believe our findings support the notion that the technique should also be considered as the first-line procedure for GON.KeywoRds: Headache, Greater occipital neuralgia, Surgical decompression ÖZ AMAÇ: Büyük oksipital nevralji için büyük oksipital sinirin mikrocerrahi dekompresyonunun klinik etkisini değerlendirmek. yÖNTeM ve GeReÇLeR: Yetmiş altı hastada büyük oksipital sinirin cerrahi dekompresyonu yapılmıştır. Ameliyattan önce bir sinir bloğu test edilmiştir. Başağrısı sinir gövdesi yakınındaki hassas bölgeye %1 Lidokain infiltrasyonuyla hızlı bir şekilde geçmiştir. BULGULAR:Yetmiş altı hasta için 89 işlem yapıldı. Ortalama takip süresi 20 ay olmuştur (ortalama 7-52 ay). Altmış sekiz hastanın (%89,5) başağrısı belirtileri tamamen geçerken ayrıca 5 (%6,6) hastada daha ileri tıbbi tedavi gerektirmeyecek şekilde önemli ölçüde geçmiştir. Üç (%3,9) hastada olay tekrarlamıştır. Tüm hastalar büyük oksipital sinirin enervasyon sağladığı bölgede hipoestezi yaşamıştır. Cerrahiden sonra 1-6 ay içinde zamanla iyileşme görülmüştür. soNUÇ: Makör oksipital sinirin mikro cerrahi dekompresyonu majör oksipital nöralji için güvenli ve etkin bir yöntemdir. Bulgularımızın bu tekniğin büyük oksipital nevralji için birinci basamak tedavi olarak düşünülmesini desteklediğine inanıyoruz.ANAHTAR sÖZCÜKLeR: Başağrısı, Büyük oksipital nevralji, Cerrahi dekompresyon

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“…It then courses between the inferior capitis oblique and semispinalis capitis muscles. [141015] According to Bovim et al .,[2] the GON pierces the trapezius muscle in 45% of cases, the semispinalis muscle in 90% of cases, and the inferior oblique muscle in 7.5% of cases. These locations where the GON pierces the various muscles can potentially cause nerve compression.…”

Section: Anatomy Of the Innervation Of The Scalpmentioning

confidence: 99%

The innervation of the scalp: A comprehensive review including anatomy, pathology, and neurosurgical correlates

Rs²,

Cohen-Gadol³

2011

Surg Neurol Int

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Background:Neurosurgical intervention involving the scalp may cause neuralgia or other pain syndromes. Therefore, a comprehensive understanding of scalp innervation may be helpful in prevention of pain potentially induced by surgery.Methods:Using standard search engines, a review of the literature regarding the anatomy of the nerves that innervate the scalp was performed with attention given to anatomic landmarks.Results:This paper provides a comprehensive review of the anatomy, embryology, pathology, and neurosurgical application of the knowledge of the innervation of the scalp.Conclusions:Knowledge of the nerves that supply the scalp is important to the neurosurgeon who hopes to maximize patient recovery and minimize post-procedural complications.

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Greater Occipital Nerve Neuralgia Caused by Pathological Arterial Contact: Treatment by Surgical Decompression

Cited by 30 publications

References 12 publications

Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve

Hemifacial Pain and Hemisensory Disturbance Referred from Occipital Neuralgia Caused by Pathological Vascular Contact of the Greater Occipital Nerve

Micro-surgical decompression for greater occipital neuralgia

The innervation of the scalp: A comprehensive review including anatomy, pathology, and neurosurgical correlates

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