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J Neurol Surg A Cent Eur Neurosurg 2022; 83(05): 461-470
DOI: 10.1055/s-0041-1739228
Original Article

Decompression of the Greater Occipital Nerve for Occipital Neuralgia and Chronic Occipital Headache Caused by Entrapment of the Greater Occipital Nerve

Byung-chul Son 
1   Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
2   Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Abstract

Background Chronic entrapment of the greater occipital nerve (GON) can not only manifest in typical stabbing pain of occipital neuralgia (ON) but also lead to continuous ache and pressure-like pain in the occipital and temporal areas. However, the effect of GON decompression on these symptoms has yet to be established. We report the follow-up results of GON decompression in typical cases of ON and chronic occipital headache due to GON entrapment (COHGONE).

Methods A 1-year follow-up study of GON decompression was conducted on 11 patients with typical ON and 39 COHGONE patients with GON entrapment. The degree of pain reduction was analyzed using the numerical rating scale-11 (NRS-11) score and percent pain relief before and 1 year after surgery. A success was defined by at least a 50% reduction in pain measured via NRS-11 during the 12-month follow-up. To assess the degree of subjective satisfaction, a 10-point Likert scale was used. Postoperative outcome was also evaluated using the Barrow Neurological Institute (BNI) pain intensity score. The difference in GON decompression between the patients with typical ON and those with COHGONE was studied.

Results GON decompression was successful in 43 of 50 patients (86.0%) and percent pain relief was 72.99 ± 25.53. Subjective improvement based on a 10-point Likert scale was 7.9 ± 2.42 and the BNI grade was 2.06 ± 1.04. It was effective in both the ON and COHGONE groups, but the success rate was higher in the ON group (90.9%) than in the COHGONE group (84.6%), showing statistically significant differences in the results based on average NRS-11 score, percent pain relief, subjective improvement, and BNI grades (p < 0.05, independent t-test).

Conclusion GON decompression is effective in chronic occipital headache and in ON symptoms induced by GON entrapment.

Keywords

decompression - greater occipital nerve - headache - migraine - occipital neuralgia


Publication History

Received: 24 October 2020

Accepted: 23 April 2021

Article published online:
06 January 2022

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