scholarly journals Ultrasound-Guided Greater Occipital Nerve Blocks and Pulsed Radiofrequency Ablation for Diagnosis and Treatment of Occipital Neuralgia

2013 ◽  
Vol 3 (2) ◽  
pp. 256-9 ◽  
Author(s):  
Matthew David VanderHoek ◽  
Hieu T Hoang ◽  
Brandon Goff
Keyword(s):  
Radiofrequency Ablation ◽  
Diagnosis And Treatment ◽  
Occipital Neuralgia ◽  
Pulsed Radiofrequency ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Occipital Nerve ◽  
Greater Occipital Nerve

scholarly journals Cooled Radiofrequency Ablation for Bilateral Greater Occipital Neuralgia

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Tiffany Vu ◽  
Akhil Chhatre
Keyword(s):  
Radiofrequency Ablation ◽  
Side Effects ◽  
Medical Literature ◽  
Current Medical ◽  
Occipital Neuralgia ◽  
Pulsed Radiofrequency ◽  
Occipital Nerve ◽  
Greater Occipital Nerve ◽  
History Of

This report describes a case of bilateral greater occipital neuralgia treated with cooled radiofrequency ablation. The case is considered in relation to a review of greater occipital neuralgia, continuous thermal and pulsed radiofrequency ablation, and current medical literature on cooled radiofrequency ablation. In this case, a 35-year-old female with a 2.5-year history of chronic suboccipital bilateral headaches, described as constant, burning, and pulsating pain that started at the suboccipital region and radiated into her vertex. She was diagnosed with bilateral greater occipital neuralgia. She underwent cooled radiofrequency ablation of bilateral greater occipital nerves with minimal side effects and 75% pain reduction. Cooled radiofrequency ablation of the greater occipital nerve in challenging cases is an alternative to pulsed and continuous RFA to alleviate pain with less side effects and potential for long-term efficacy.

Occipital Nerve Blocks for Relief of Headaches in Patients With Ventriculoperitoneal Shunts: A Case Series

2019 ◽  
Vol 34 (11) ◽  
pp. 674-678 ◽  
Author(s):  
Eugene Kim ◽  
Giovanni Cucchiaro
Keyword(s):  
Pediatric Patients ◽  
Case Series ◽  
Therapeutic Interventions ◽  
Shunt Revision ◽  
Occipital Neuralgia ◽  
Pulsed Radiofrequency ◽  
Nerve Blocks ◽  
Ventriculoperitoneal Shunts ◽  
Occipital Nerve ◽  
History Of

Pediatric patients with ventriculoperitoneal shunts commonly present with headaches. We report 7 children with ventriculoperitoneal shunts and occipital headaches who received occipital nerve blocks. Eighty-six percent of patients had a history of at least 1 ventriculoperitoneal shunt revision. Headaches improved in every patient after the block. Two patients (29%) were symptom free 11 and 12 months after the block. Four patients (57%) required repeat occipital nerve blocks. Two underwent pulsed radiofrequency ablation. No complications were noted. When patients with ventriculoperitoneal shunts present with headaches, a detailed physical examination is necessary. Persistent occipital headaches with tenderness and radiation in the path of the occipital nerves can be indicative of occipital neuralgia resulting from the shunt having crossed over the path of the greater or lesser occipital nerve. Occipital nerve blocks can help as both diagnostic and therapeutic interventions in these patients.

scholarly journals Pulsed radiofrequency on the occipital nerve for treatment of short-lasting unilateral neuralgiform headache: A case report

2020 ◽  
Vol 3 ◽  
pp. 251581632090826
Author(s):  
Fatima López Gonzalez ◽  
Isabel Beltrán Blasco ◽  
Cesar Margarit Ferri
Keyword(s):  
Transient Response ◽  
Positive Response ◽  
Pulsed Radiofrequency ◽  
Conjunctival Injection ◽  
Nerve Blocks ◽  
Trigeminal Autonomic Cephalalgia ◽  
Occipital Nerve ◽  
Greater Occipital Nerve ◽  
Reduction Of Pain ◽  
Ablative Procedures

Short-lasting unilateral neuralgiform headache (Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing (SUNCT)/Short-lasting Unilateral Neuralgiform headache attacks with Autonomic Symptoms) is a trigeminal autonomic cephalalgia with difficult treatment and its management is based on neuromodulator drugs and sometimes ablative procedures on the trigeminal nerve. A positive response to occipital anesthetic blocks and peripheral and deep neurostimulation has also been described. We present the case of a patient with criteria of left SUNCT and transient response to occipital anesthetic blocks, satisfactorily controlled with pulsed radiofrequency (PRF) of the occipital nerve. Upon examination, the patient had tenderness in the left greater occipital nerve (GON). Blockade was performed with anesthetic and corticosteroid, obtaining a highly positive but transient response. After several nerve blocks, the patient was referred to the Pain Unit where pulsed radiofrequency on the left GON was performed. After two sessions, more than 90% of reduction of pain was achieved, maintained for 12 months. There haven’t been found data in the literature on the use of GON PRF for the treatment of SUNCT, while there are descriptions for other types of cranial pain. The intention of our case is to make this procedure to be considered as an alternative for the treatment of this entity in patients who respond to anesthetic blocks.

scholarly journals Ultrasound-Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study

2016 ◽  
Vol 7;19 (7;9) ◽  
pp. E1027-E1034 ◽  
Author(s):  
Jonathan Zipfel
Keyword(s):  
Retrospective Study ◽  
Occipital Neuralgia ◽  
Technical Success ◽  
Ultrasound Guided ◽  
Technical Feasibility ◽  
Occipital Nerve ◽  
Pain Syndromes ◽  
Greater Occipital Nerve ◽  
Craniofacial Pain ◽  
Block Test

Background: Two studies recently reported that computed tomography (CT) guided infiltration of the greater occipital nerve at its intermediate site allows a high efficacy rate with long-lasting pain relief following procedure in occipital neuralgia and in various craniofacial pain syndromes. Objective: The purpose of our study was to evaluate the technical feasibility and safety of ultrasound-guided intermediate site greater occipital nerve infiltration. Study Design: Retrospective study. Setting: This study was conducted at the imaging department of a 1,409 bed university hospital. Methods: Local institutional review board approval was obtained and written consent was waived. In this retrospective study, 12 patients suffering from refractory occipital neuralgia or craniofacial pain syndromes were included between April and October 2014. They underwent a total of 21 ultrasound-guided infiltrations. Infiltration of the greater occipital nerve was performed at the intermediate site of the greater occipital nerve, at its first bend between obliqus capitis inferior and semispinalis capitis muscles with local anestetics and cortivazol. Technical success was defined as satisfactory diffusion of added iodinated contrast media in the fatty space between these muscles depicted on control CT scan. We also reported first data of immediate block test efficacy and initial clinical efficacy at 7 days, one month, and 3 months, defined by a decrease of at least 50% of visual analog scale (VAS) scores. Results: Technical success rate was 95.24%. Patients suffered from right unilateral occipital neuralgia in 3 cases, left unilateral occipital neuralgia in 2 cases, bilateral occipital neuralgia in 2 cases, migraine in one case, cervicogenic headache in one case, tension-type headache in 2 cases, and cluster headache in one case. Block test efficacy was found in 93.3% (14/15) cases. Clinical efficacy was found in 80% of cases at 7 days, in 66.7% of cases at one month and in 60% of cases at 3 months. No major complications were noted. Limitations: Some of the limitations of our study include that it represents a single institution. The low number of infiltrations included in this study, for this guidance procedure, is another bias. Conclusions: This ultrasound-guided infiltration technique appears to be feasible, safe, nonionizing, and fast when targeting the greater occipital nerve in its intermediate portion. This imaging guidance modality should be used in routine clinical practice. Key words: Greater occipital nerve, infiltration, ultrasound guidance, corticosteroids, occipital neuralgia, craniofacial pain syndrome

scholarly journals Sphenopalatine Ganglion versus Greater Occipital Nerve Blocks in Treating Post-Dural Puncture Headache after Spinal Anesthesia for Cesarean Section: A Randomized Clinical Trial

2021 ◽  
pp. E443-E451
Keyword(s):  
Cesarean Section ◽  
Dural Puncture ◽  
Sphenopalatine Ganglion ◽  
Ganglion Block ◽  
Nerve Blocks ◽  
Neck Stiffness ◽  
Post Dural Puncture Headache ◽  
Occipital Nerve ◽  
Greater Occipital Nerve ◽  
Blood Patch

BACKGROUND: Despite being invasive, with serious complications, epidural blood patch (EBP) is still considered the gold standard therapy for Post Dural Puncture Headache (PDPH). The use of Peripheral nerve blocks for PDPH are studied here. OBJECTIVES: To investigate the efficacy of sphenopalatine ganglion block (SPGB) and greater occipital nerve block (GONB) to relieve PDPH and its associated symptoms. STUDY DESIGN: Randomized comparative single-blind trial. SETTING: A University hospital. METHODS: Patients who received spinal anesthesia for elective cesarean section, and then developed PDPH during hospitalization or within 5 days after dural puncture were enrolled to receive GONB (n = 47) or SPGB (n = 46) for treatment of PDPH. GONB Group: Patients received bilateral GONB using 3 mL mixture of 2 mL lidocaine 2% plus 1 mL dexamethasone 4 mg on each side of occipital region. SPGB Group: Patients received bilateral SPGB using the same mixture in each nostril. Assessments included Numeric Rating Scale (NRS) for severity of headache at supine and sitting positions, nausea NRS, neck stiffness, need for EBP, and complications. RESULTS: The supine and sitting headache NRS scores significantly decreased at 30 minutes after blocks and throughout follow-up period in both groups (P < 0.000). Clinically significant drop of NRS to < 4 was reached earlier in GONB group. There was a significant difference between groups after 2 hours in supine and sitting headache NRS scores (P = 0.020 and 0.030, respectively); however, both treatments showed similar effectiveness from the third hour afterwards (P > 0.05). Both techniques were effective in relieving neck stiffness and nausea (P < 0.000), with no adverse effects. LIMITATIONS: A limitation to this study was the small sample size. CONCLUSIONS: GONB and SPGB are equally effective in relieving symptoms of PDPH. Both techniques are safe, simple, and less invasive than EBP. KEY WORDS: Cesarean Section, epidural blood patch greater occipital nerve block, post-dural puncture headache, sphenopalatine ganglion block

Greater Occipital Nerve Decompression for Occipital Neuralgia

2018 ◽  
Vol 29 (5) ◽  
pp. e518-e521 ◽  
Author(s):  
Anson Jose ◽  
Shakil Ahmed Nagori ◽  
Probodh K. Chattopadhyay ◽  
Ajoy Roychoudhury
Keyword(s):  
Occipital Neuralgia ◽  
Occipital Nerve ◽  
Nerve Decompression ◽  
Greater Occipital Nerve
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