Most patients with primary headache syndromes who have frequent attacks of pain have tenderness in the sub-occipital region. Injection of the greater occipital nerve (GON) with local anesthetic and corticosteroids has been widely used in clinical practice for many years, yet there is no clear understanding of its mechanisms of action. Moreover, there is no current gold-standard of practice rega...

In his 1948 headache book, Harold Wolff described 3 types of occipital neuralgia.“The first and most common is characterized by a long-lasting (day, weeks, or months), more or less sustained aching of low or moderate intensity. It is commonly bilateral but may be unilateral. It is associated with stiffness of the muscles of the neck, tender points, often with muscle nodules, and with head tilti...

METHODS: A retrospective chart review was performed at a tertiary academic medical center for all patients who underwent microvascular surgery of the scalp from July 2011 through December 2016. Reconstructions were evaluated by type of flap utilized (myofascial, myocutaneous, fasciocutaneous, or osteocutaneous) as well as type of cranial reconstruction performed (titanium implant, polyetherethe...

BACKGROUND Despite a favorable clinical experience, little evidence exists for the efficacy of greater occipital nerve block (GONB) in migraine treatment. Considering such a premise, we wished to evaluate the therapeutic efficacy of GONB in patients affected by migraine headaches. METHODS A randomized double-blinded controlled trial was conducted on 48 patients suffering from migraine headach...

BACKGROUND To use sonography to measure the cross-sectional area (CSA) of the greater occipital nerve (GON) and the adjacent obliquus capitis inferior muscle (OCI) in normal subjects. METHODS Data from 30 asymptomatic subjects between the ages of 22 and 35 were collected. CSA and circumference of the GON and CSA of OCI were measured using sonography. Interexaminer reliability analysis was per...

Patients with primary headaches often report pain that involves not only the front of the head, innervated by the first (ophthalmic) division of the trigeminal nerve, but also the back of the head, innervated by the greater occipital nerve (GON) that is a branch of the C(2) spinal root. The aim of this work was to study the physiology of trigeminocervical input in a model of cranial nociception...