Occipital Nerve Block

Indications

Occipital Headache
- Pain radiates from occiput anteriorly-secondary to compression as nerve exits (fibrosis, muscle spasm etc.)
Occipital Neuralgia
- Pain radiates from the greater occipital nerve, lesser occipital nerve, third occipital nerves, or a combination of the three

Clinical Significance

Patients of all ages frequently report headaches, which is a typical clinical complaint in many medical specialties. The condition is often burdensome, can impair quality of life for patients, and is linked to a significant socioeconomic burden
When treating both acute and persistent headaches, the greater occipital nerve block is a useful therapeutic option. Even for individuals with various comorbidities

Locating the Occipital Nerve

Locate Atlas, then Axis
C2 bifid spinous process
Locate Obliquis Capitis Inferior Muscle
Lamina of Axis and Transverse Process of Atlas
Greater Occipital nerve hyper echoic above Obliquis Capitis muscle
CPT 64405 76942

Contraindications

Patient refusal
Anesthetic allergy
Open skull defect
Infection

References

and Interesting Articles

Austin M, Hinson MR. Occipital Nerve Block. [Updated 2022 Sep 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK580523/
Djavaherian DM, Guthmiller KB. Occipital Neuralgia. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538281/
Fernandes L, Randall M, Idrovo LPeripheral nerve blocks for headache disordersPractical Neurology 2021;21:30-35.
Mungoven TJ, Henderson LA, Meylakh N. Chronic Migraine Pathophysiology and Treatment: A Review of Current Perspectives. Front Pain Res (Lausanne). 2021 Aug 25;2:705276. doi: 10.3389/fpain.2021.705276. PMID: 35295486; PMCID: PMC8915760
Cesmebasi A, Muhleman MA, Hulsberg P, Gielecki J, Matusz P, Tubbs RS, Loukas M. Occipital neuralgia: anatomic considerations. Clin Anat. 2015 Jan;28(1):101-8. doi: 10.1002/ca.22468. Epub 2014 Sep 22. PMID: 25244129.

Disclaimer

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