An Anatomical Study of the Lesser Occipital Nerve and Its Potential Compression Points

Abstract

This anatomical study traced the lesser occipital nerve as it courses through the posterior scalp and mapped its potential decompression sites.

Emergence of Secondary Trigger Sites after Primary Migraine Surgery

“…Since the inception of migraine surgery, the impact of other nerve branches such as the auriculotemporal, third occipital, and lesser occipital has come to play a significant role. 17,18,22,[28][29][30] These anatomical overlaps and irritation of the smaller peripheral branches may cloud the ability to adequately locate the correct site or nerve for decompression. More recently, the senior author has found that a handheld Doppler probe will almost invariably locate an arterial signal near a residual or new pain site, indicating a close association with vascular irritation.…”

Surgical “Safe Zone”: Rapid Anatomical Identification of the Lesser Occipital Nerve

“…It provides sensory innervation to a relatively small area of the posterolateral head and neck, including the superior ear, lateral neck, and posterior auricular skin. 2,15 The course of the nerve, including its relationships to the surrounding landmarks and potential points of compression, has been an active area of research, 8,9,16,17 particularly with recent advancements in the surgical management of occipital neuralgia. 2 Because the LON provides sensation to a relatively small area, one common operative strategy is direct resection of the nerve.…”

Anatomical Regional Targeted (ART) BOTOX Injection Technique: A Novel Paradigm for Migraines and Chronic Headaches

“…The LON is similarly injected in both an “anatomical” and “targeted” fashion, with injections modified to conform to the point of maximal tenderness commonly within 0.5 cm of the described anatomical landmark posterior to the sternocleidomastoid. 11 Additionally, there can be point tenderness in the distal “tail of the GON or LON” as they course over the mastoid and the superior/medial areas of the ear, where they can intertwine with the terminal branches of the occipital artery. (We have not had any issues injecting close to the vessels in the occipital area.…”