Anatomy of the lesser occipital nerve in relation to cervicogenic headache

Lucas, Guilherme; Laudanna, Adriana; Chopard, Renato Paulo; Raffaelli, Edgard

doi:10.1002/ca.980070207

Cited by 26 publications

(9 citation statements)

References 20 publications

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“…51 Compression or stretching in multiple segments along this nerve or from its relationship with the superior cervical ganglion or the ophthalmic branch of the trigeminal nerve may trigger this site. 52 In the same manner of trigger site IV, our results observed success after trigger site VI deactivation only at 12-month follow-up. There were no other studies that evaluated surgical outcomes of this trigger site alone.…”

Section: Trigger Site VImentioning

confidence: 49%

“Migraine Surgery and Determination of Success Over Time by Trigger Site: A Systematic Review of the Literature”

Huayllani

Janis

2022

Plastic &Amp; Reconstructive Surgery

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Background: Migraine headache is a debilitating disorder that produces high costs and compromises patient quality of life. This study aimed to evaluate surgery success and the longevity of the surgical benefit by trigger site. Methods: A systematic literature review was performed by querying the PubMed, Embase, Scopus, and Web of Science databases. The keywords “surgery,” “migraine,” “outcomes,” “headache index,” and synonyms in titles and abstracts were used to perform the search. Results: A total of 17 articles published between 2009 and 2019 met the inclusion criteria. Six studies were prospective and 11 were retrospective. Most of the studies (77.8%, 77.8%, and 80%, respectively) reported success of migraine surgery at 12-month follow-up for trigger sites I, II, and III, respectively. For trigger site IV, the greatest Migraine Headache Index reduction (93.4%) was observed at 12-month follow-up, and the earliest Migraine Headache Index reductions (80.3% and 74.6%) were observed at 6-month follow-up. All studies that evaluated trigger sites V and VI identified surgery success at 12-month follow-up. Migraine surgery was found to remain beneficial at 22 months for trigger sites I, II, III, and IV. Conclusions: The symptomatic improvement may initially be evident at 6 months for trigger site IV and at 12 months for trigger sites I, II, III, V, and VI. Surgical benefit in trigger sites I, II, III, and IV can persist after 22 months. Further studies are required to evaluate results at longer follow-up.

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Section: Trigger Site VImentioning

confidence: 49%

“Migraine Surgery and Determination of Success Over Time by Trigger Site: A Systematic Review of the Literature”

Huayllani

Janis

2022

Plastic &Amp; Reconstructive Surgery

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“…Occipital neuralgia due to GON pathophysiology includes compression of the GON between the atlas and axis causing severe pain when the head is rotated, irritation of the GON as it passes between the obliquus capitis inferior muscle and the SSC muscle, compression of the GON due to close proximity to the occipital artery, and GON schwannoma 10–14 . Lesser occipital nerve pain from stretching of the C2 ventral ramus by the obliquus capitis inferior muscle during forceful movements, compression of the C2 ventral ramus as it crosses the atlantoaxial junction, and vascular compression by the vertebral artery 12,15 . Rarely, ON can be due to TON entrapment from the C2 to C3 facet joint 16 .…”

mentioning

confidence: 99%

“…[10][11][12][13][14] Lesser occipital nerve pain from stretching of the C2 ventral ramus by the obliquus capitis inferior muscle during forceful movements, compression of the C2 ventral ramus as it crosses the atlantoaxial junction, and vascular compression by the vertebral artery. 12,15 Rarely, ON can be due to TON entrapment from the C2 to C3 facet joint. 16 Other suggested causes include posterior head or whiplash injuries, nerve damage after posterior cervical or cranial surgery, space occupying lesions, tumors, osteoarthritis, localized infection or inflammation, vasculitis, gout, diabetes, or even long periods of keeping the head in a downward position.…”

mentioning

confidence: 99%

An Update on the Diagnosis, Treatment, and Management of Occipital Neuralgia

Swanson

Guedry²,

Boudreaux³

et al. 2021

Journal of Craniofacial Surgery

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This report intends to summarize the underlying pathophysiology, relevant symptoms, appropriate diagnostic workup, necessary imaging, and medical and surgical treatments of occipital neuralgia (ON). This was done through a comprehensive literature review of peer-reviewed literature throughout the most relevant databases. The current understanding of ON is that it causes neuropathic pain in the distribution of the greater occipital nerve, the lesser occipital nerve, the third occipital nerve or a combination of the 3. It is currently a subset of headaches although there is some debate if ON should be its own condition. Occipital neuralgia causes chronic, sharp, stabbing pain in the upper neck, back of the head, and behind the ears that can radiate to the front of the head. Diagnosis is typically clinical and patients present with intermittent, painful episodes associated with the occipital region and the nerves described above. Most cases are unilateral pain, however bilateral pain can be present and the pain can radiate to the frontal region and face. Physical examination is the first step in management of this disease and patients may demonstrate tenderness over the greater occipital and lesser occipital nerves. Anesthetics like 1% to 2% lidocaine or 0.25% to 0.5% bupivacaine can be used to block these nerves and antiinflammatory drugs like corticosteroids can be used in combination to prevent compressive symptoms. Other treatments like botulinum toxin and radiofrequency ablation have shown promise and require more research. Surgical decompression through resection of the obliquus capitis inferior is the definitive treatment however there are significant risks associated with this procedure.

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“…Duplication of the LON has been reported by Lucas et al and Gupta et al [4,5], while Madhavi and Holla reported a case in which the LON was triplicated bilaterally [6]. Another rare variation reported was the passage of the LON through the "carefree" region of the posterior triangle [7].…”

Section: Discussionmentioning

confidence: 92%

A Rare Anatomical Variation of the Lesser Occipital Nerve

Chabot¹,

Iwanaga²,

Dumont³

et al. 2021

Cureus

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The lesser occipital nerve (LON) is a cutaneous branch of the cervical plexus that arises from the second and sometimes the third spinal nerve and innervates the scalp. During routine dissection of the neck, the LON was observed to arise directly from the spinal accessory nerve. The aberrant nerve measured 1.9 mm in diameter and 10.2 cm in length. Although anatomical variations of the LON such as duplication and triplication have been observed, we believe the origination of this nerve directly and exclusively from the spinal accessory nerve is exceedingly rare. The current case adds to the sparse literature on the variations of the LON and might be of interest to clinicians treating neurological conditions or surgeons operating in the area.

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Anatomy of the lesser occipital nerve in relation to cervicogenic headache

Cited by 26 publications

References 20 publications

“Migraine Surgery and Determination of Success Over Time by Trigger Site: A Systematic Review of the Literature”

“Migraine Surgery and Determination of Success Over Time by Trigger Site: A Systematic Review of the Literature”

An Update on the Diagnosis, Treatment, and Management of Occipital Neuralgia

A Rare Anatomical Variation of the Lesser Occipital Nerve

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