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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cervicogenic headache (CEH) has been said to be common among patients with idiopathic headache, but no information exists as to its prevalence among those who have not suffered whiplash or head injury. This study was designed to answer this question and in addition to determine whether headache relief could be achieved by blockade of the occipital nerves (greater and lesser occipital--GON, LON) in the upper neck, on the side habitually affected by the headache. Among 796 patients with idiopathic headache, 128 or 16.1% were found to be suffering from CEH. They were predominantly female, as in the case of migraine, older than the migrainous group (49.5 years as against 34.7 years), respectively, and with a monthly headache frequency of 18, against 6.9 in the case of migraine. Injections of depot methylprednisolone into the region of the GON and LON produced complete relief of headache in 169 out of 180 patients with CEH for a period ranging from 10 to 77 days, the mean duration of relief being 23.5 days. However, similar relief of headache could be achieved in patients with attacks of strictly unilateral migraine or cluster headache, suggesting that local steroid injections by blocking the cervico-trigeminal relay, can arrest other forms of unilateral headache.
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PMID:Cervicogenic headache: prevalence and response to local steroid therapy. 1082 89

Occipital neuralgia is usually defined as paroxysmal stabbing pain in the greater or lesser occipital nerve (GON or LON) distribution. In occipital neuralgia patients, surgical considerations are carefully taken into account if medical management is ineffective. However, identification of the occipital artery by palpation in patients with thick necks or small occipital arteries can be technically difficult. Therefore, we established a new technique using transcranial Doppler (TCD) sonography for more accurate and rapid identification. The patient was a 64-year-old man who had undergone C1-C3 screw fixation and presented with intractable stabbing pain in the bilateral GON and LON distributions. In cases in which pain management was performed using medication, physical therapy, nerve block, or radiofrequency thermocoagulation, substantial pain relief was not consistently achieved, and recurrence of pain was reported. Therefore, we performed occipital neurectomy of the bilateral GON and LON by using TCD sonography, which helped detect the greater occipital artery easily. After the operation, the patient's headache disappeared gradually, although he had discontinued all medication except antidepressants. We believe that this new technique of occipital neurectomy via a small skin incision performed using TCD sonography is easy and reliable, has a short operative time, and provides rapid pain relief.
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PMID:A case of occipital neuralgia in the greater and lesser occipital nerves treated with neurectomy by using transcranial Doppler sonography: technical aspects. 2139 Jan 79