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Occipital nerve

Thomas Beez, Jennifer Brown
BACKGROUND: Atlanto-occipital dislocation (AOD) is a rare but severe sequela of high energy trauma. Children are at increased risk, due to their immature spine and biomechanical characteristics. LITERATURE REVIEW: The prevailing mechanism of injury is motor vehicle collision as passenger. AOD commonly presents with cardiorespiratory arrest, spinal cord injury or cranial nerve deficits. Concomitant injuries, such as traumatic brain injury, are frequently encountered...
October 18, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Christina L Szperka, Amy A Gelfand, Andrew D Hershey
OBJECTIVE: To describe current patterns of use of nerve blocks and trigger point injections for treatment of pediatric headache. BACKGROUND: Peripheral nerve blocks are often used to treat headaches in adults and children, but the available studies and practice data from adult headache specialists have shown wide variability in diagnostic indications, sites injected, and medication(s) used. The purpose of this study was to describe current practice patterns in the use of nerve blocks and trigger point injections for pediatric headache disorders...
October 12, 2016: Headache
David Daewhan Kim, Nabil Sibai
INTRODUCTION: Greater occipital nerve blocks (GONB) have been used for headache but their benefit may be short. Ready et al performed intrathecal injections on rabbits and reported neurologic/histologic changes that required concentrations of at least 8%. Our study tests the hypothesis that the neurolytic effects of GONB with 10% lidocaine can prolong relief. METHODS: After an approval from Henry Ford Hospital Institutional Review Board, a chart review was performed for patients who had GONB with 10% lidocaine...
2016: Journal of Pain Research
Denys Fontaine, Serge Blond, Christian Lucas, Jean Regis, Anne Donnet, Stéphane Derrey, Evelyne Guegan-Massardier, Bechir Jarraya, Bich Dang-Vu, Frederic Bourdain, Dominique Valade, Caroline Roos, Christèle Creach, Stéphan Chabardes, Pierric Giraud, Jimmy Voirin, Jocelyne Bloch, Alda Rocca, Sophie Colnat-Coulbois, Francois Caire, Coralie Roger, Sylvie Romettino, Michel Lanteri-Minet
BACKGROUND: Occipital nerve stimulation (ONS) has been proposed to treat chronic medically-intractable cluster headache (iCCH) in small series of cases without evaluation of its functional and emotional impacts. METHODS: We report the multidimensional outcome of a large observational study of iCCH patients, treated by ONS within a nationwide multidisciplinary network ( NCT01842763), with a one-year follow-up. Prospective evaluation was performed before surgery, then three and 12 months after...
October 3, 2016: Cephalalgia: An International Journal of Headache
Koichi Watanabe, Tsuyoshi Saga, Joe Iwanaga, Yoko Tabira, Koh-Ichi Yamaki
INTRODUCTION: The transversus nuchae muscle appears inconsistently in the occipital region. It has gained attention as one of the muscles composing the superficial musculoaponeurotic system (SMAS). The purpose of this study was to clarify its detailed anatomical features. MATERIALS AND METHODS: We examined 124 sides of 62 cadavers. The transversus nuchae muscle was identified when present and examined after it had been completely exposed. We also examined its relationship to the occipital cutaneous nerves...
September 29, 2016: Clinical Anatomy
Kevin D'Ostilio, Delphine Magis
Chronic primary headaches are widespread disorders which cause significant quality of life and socioprofessional impairment. Available pharmacological treatments have often a limited efficacy and/or can generate unbearable side effects. Electrical nerve stimulation is a well-known non-destructive method of pain modulation which has been recently applied to headache management. In this review, we summarise recent advances in invasive and non-invasive neurostimulation techniques targeting pericranial structures for the treatment of chronic primary headaches, chiefly migraine and cluster headache: occipital nerve, supraorbital nerve, vagus nerve, and sphenopalatine ganglion stimulations...
November 2016: Current Pain and Headache Reports
Olga A Lyubashina, Sergey S Panteleev, Alexey Y Sokolov
Electrical stimulation of the greater occipital nerve (GON) has recently shown promise as an effective non-pharmacological prophylactic therapy for drug-resistant chronic primary headaches, but the neurobiological mechanisms underlying its anticephalgic action are not elucidated. Considering that the spinal trigeminal nucleus (STN) is a key segmental structure playing a prominent role in pathophysiology of headaches, in the present study we evaluated the effects of GON electrical stimulation on ongoing and evoked firing of the dura-sensitive STN neurons...
September 27, 2016: Journal of Neural Transmission
Sayed E Wahezi, Kyle Silva, Naum Shaparin, Andrew Lederman, Mohammed Emam, Nogah Haramati, Sherry A Downie
BACKGROUND: Headache (HA) is a significant cause of morbidity globally. Despite many available treatment options, HAs that are refractory to conservative management can be challenging to treat. Third occipital nerve (TON) and greater occipital nerve (GON) irritation are potential etiologic agents of primary and cervicogenic HAs that can be targeted using minimally invasive treatment options such as nerve blocks or radiofrequency ablation. However, a substantial number of patients that undergo radiofrequency ablation do not experience pain relief despite a positive diagnostic medial branch block (MBB)...
September 2016: Pain Physician
Jonathan Zipfel, Adrian Kastler, Laurent Tatu, Julien Behr, Rachid Kechidi, Bruno Kastler
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...
September 2016: Pain Physician
Thomas P Pittelkow, Gabriel L Pagani-Estevez, Bradford Landry, Matthew J Pingree, Jason S Eldrige
BACKGROUND: Occipital neuromodulation is a promising treatment modality for refractory headache, but lead migration remains a frequent surgical complication. OBJECTIVES: The primary objective was to identify surgical techniques that may minimize adverse events, particularly lead migration. We hypothesized that a surgical technique employing 2-point anchoring of stimulator leads designed to provide a tension-relief loop and the use of ultrasound for lead placement would decrease the complication rate...
September 2016: Pain Physician
Ö Karadaş, A Ö Özön, F Özçelik, A Özge
OBJECTIVES: This study aims to investigate the efficiency of a single and repeated greater occipital nerve (GON) block using lidocaine in the treatment of triptan-overuse headache (TOH), whose importance has increased lately. MATERIALS AND METHODS: In the study, 105 consecutive subjects diagnosed with TOH were evaluated. The subjects were randomized into three groups. In Group 1 (n=35), only triptan was abruptly withdrawn. In Group 2 (n=35), triptan was abruptly withdrawn and single GON block was performed...
September 26, 2016: Acta Neurologica Scandinavica
Ushio Hanai, Tadashi Akamatsu, Megumi Kobayashi, Yotaro Tsunoda, Kenichi Hirabayashi, Tanehumi Baba, Hideki Atsumi, Mitsunori Matsumae
INTRODUCTION: The prognosis of malignant peripheral nerve sheath tumor (MPNST) with neurofibromatosis type 1 (NF-1) is worse than that of a solitary MPNST, because of the tumor size and location difficult to resect completely. We experienced a case of MPNST in the occipital region with NF-1. CASE REPORT: A 59-year-old woman presented with NF-1 and an MPNST of the occipital region. We performed wide excision involving the occipital bone, and reconstructed with a titanium plate and a free latissimus dorsi muscle flap...
2016: Tokai Journal of Experimental and Clinical Medicine
Esra Uyar Türkyilmaz, Nuray Camgöz Eryilmaz, Nihan Aydin Güzey, Özlem Moraloğlu
BACKGROUND: Post-dural puncture headache (PDPH) is an important complication of neuroaxial anesthesia and more frequently noted in pregnant women. The pain is described as severe, disturbing and its location is usually fronto-occipital. The conservative treatment of PDPH consists of bed rest, fluid theraphy, analgesics and caffeine. Epidural blood patch is gold standard theraphy but it is an invasive method. The greater occipital nerve (GON) is formed of sensory fibers that originate in the C2 and C3 segments of the spinal cord and it is the main sensory nerve of the occipital region...
September 2016: Brazilian Journal of Anesthesiology
Bradley A Gross, Felipe C Albuquerque, Karam Moon, Cameron G McDougall
BACKGROUND: With the introduction of Onyx, transarterial embolization has become the most common endovascular approach to treating dural arteriovenous fistulas (dAVFs), often via the middle meningeal or occipital arteries. The ascending pharyngeal artery (APA) is a less frequently explored transarterial route because of its small caliber, potential anastomoses to the internal carotid and vertebral arteries, and vital supply to lower cranial nerves. OBJECTIVE: To review our institutional experience and highlight the prevalence of APA supply to dAVFs and cases where it is a safe and effective pedicle for embolization...
August 31, 2016: Journal of Neurointerventional Surgery
P-J Finiels, D Batifol
OBJECTIVE: To present the current treatment options for occipital neuralgia based on a retrospective series of 111 patients, who were offered one or more treatment methods, not mutually exclusive. METHODS: All patients, who previously had their diagnosis confirmed by undergoing an anesthetic nerve block (0.25mL bupivacaine/2mL cortivazol), were treated by radiofrequency denaturation in 78 cases, injection of botulinum toxin in 37 cases and implantation of a nerve stimulation system in 5 cases...
August 18, 2016: Neuro-Chirurgie
Robert R Hagan, Michael A Fallucco, Jeffrey E Janis
BACKGROUND: Supraorbital rim syndrome (SORS) is a novel term attributed to a composite of anatomically defined peripheral nerve entrapment sites of the supraorbital rim region. The SORS term establishes a more consistent nomenclature to describe the constellation of frontal peripheral nerve entrapment sites causing frontal headache pain. In this article, we describe the anatomical features of SORS and evidence to support its successful treatment using the transpalpebral approach that allows direct vision of these sites and the intraconal space...
July 2016: Plastic and Reconstructive Surgery. Global Open
Sarah Miller, Harith Akram, Susie Lagrata, Marwan Hariz, Ludvic Zrinzo, Manjit Matharu
Short-lasting unilateral neuralgiform headache attacks are primary headache disorders characterized by short-lasting attacks of unilateral pain accompanied by autonomic features. A small minority are refractory to medical treatment. Neuroimaging studies have suggested a role of the posterior hypothalamic region in their pathogenesis. Previous case reports on deep brain stimulation of this region, now understood to be the ventral tegmental area, for this disorder are limited to a total of three patients. We present a case series of 11 new patients treated with ventral tegmental area deep brain stimulation in an uncontrolled, open-label prospective observational study...
August 14, 2016: Brain: a Journal of Neurology
Nauman S Chaudhry, Faiz U Ahmad, Jacques J Morcos
Schwannomas arising from the trochlear nerve are very rare and to our knowledge, less than 35 histologically documented cases have been reported in the literature. There are no reports of a schwannoma in the pineal region. We report a 24-year-old woman who underwent a para-occipital trans-tentorial approach and gross total excision of a pineal region schwannoma arising from the trochlear nerve. This is the first such reported case.
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Sumaira Nabi, Haris Majid Rajput, Mazhar Badshah, Shahzad Ahmed
A 17-year-old Pakistani female patient presented with acute onset flaccid quadriparesis with nerve conduction studies showing demyelinating polyneuropathy consistent with Guillain-Barre' syndrome. She was treated with 4 plasmapheresis sessions. She developed raised blood pressure, headache, visual loss and generalised seizures on the 13th day of admission. MRI of the brain on contrast showed findings of altered signals low on T1-weighted image, high on T2-weighted image and fluid-attenuated inversion recovery in the white matter of bilateral occipital, parietal and right frontal lobe consistent with posterior reversible encephalopathy syndrome...
2016: BMJ Case Reports
Xin Zhang, Halima Tabani, Ivan El-Sayed, Ali Tayebi Meybodi, Dylan Griswold, Praveen Mummaneni, Arnau Benet
BACKGROUND: The expanded endoscopic endonasal ("far medial") approach to the inferior clivus provides a unique surgical corridor to the ventral surface of the ponto- and cervico-medullary junctions. However, exposing neoplasms involving the jugular foramen (JF) through this approach requires extensive nasopharyngeal resection and lateral dissection beyond the boundaries of the endonasal corridor, limiting the extent of resection and its application to expert surgeons. OBJECTIVES: To describe a multiportal endoscopic transoral and endonasal approach to maximize surgical access to the JF and clivus...
July 29, 2016: World Neurosurgery
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