Occipital neuralgia: possible failure of surgical treatment - case report.
Surgical intervention in severe cases of occipital neuralgia should be considered if pharmacological and local nerve blocking treatment fail. The literature suggests two types of interventions: surgical decompression of the greater occipital nerve (GON) from the entrapment site, as a less invasive approach, and neurotomy of the nerve trunk, which results in ipsilateral sensation deficits in the GON innervated area of the skull. Due to anatomical variations in the division of the GON trunk, typical neurotomy above the line of the trapezius muscle aponeurosis (TMA) may not result in full recovery. The present study discusses a case of a female treated with GON decompression as a result of occipital neuralgia unresponsive to pharmacotherapy, who thereafter was qualified for two consecutive neurotomies due to severe relapse of pain.
Andrychowski
Jarosław
J
Department of Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, Bielanski Hospital, Cegłowska 80, 01-809 Warsaw, Poland. neurochirurgia@bielanski.med.pl
Czernicki
Zbigniew
Z
Netczuk
Tomasz
T
Taraszewska
Anna
A
Dabrowski
Piotr
P
Rakasz
Lukasz
L
Budohoski
Karol
K
D000328:Adult; D019771:Axotomy; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D009334:Neck Muscles / Q000294:innervation; D009437:Neuralgia / Q000601:surgery*; D009777:Occipital Bone; D013127:Spinal Nerves / Q000473:pathology* / Q000601:surgery*