Document Detail


Neurovascular compression of the greater occipital nerve: implications for migraine headaches.
MedLine Citation:
PMID:  21124138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Surgical release of the greater occipital nerve has been demonstrated to be clinically effective in eliminating or reducing chronic migraine symptoms. However, migraine symptoms in some patients continue after this procedure. It was theorized that a different relationship between the greater occipital nerve and occipital artery may exist in these patients that may be contributing to these outcomes. A cadaveric investigation was performed in an effort to further delineate the occipital artery-greater occipital nerve relationship.
METHODS: Fifty sides of 25 fresh cadaveric posterior necks and scalps were dissected. The greater occipital nerve was identified within the subcutaneous tissue and its relationship with the occipital artery was delineated. A topographic map of the intersection of the two structures was created.
RESULTS: The greater occipital nerve and occipital artery have an intimate relationship, and crossed each other in 27 hemiheads (54.0 percent). The relationship between these structures when they crossed varied from a single intersection to a helical intertwining.
CONCLUSIONS: The greater occipital nerve and occipital artery have an anatomical intersection 54 percent of the time. There are two morphologic types of relationships between the structures: a single intersection point and a helical intertwining. Vascular pulsation may cause irritation of the nerve and is a possible explanation for migraine headaches that have the occipital region as a trigger point. Future imaging studies and clinical investigation is necessary to further examine the link between anatomy and clinical presentation.
Authors:
Jeffrey E Janis; Daniel A Hatef; Edward M Reece; Paul D McCluskey; Timothy A Schaub; Bahman Guyuron
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  126     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-02     Completed Date:  2011-01-07     Revised Date:  2012-03-05    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1996-2001     Citation Subset:  AIM; IM    
Affiliation:
Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390-9132, USA. jeffrey.janis@utsouthwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arteries / pathology
Female
Humans
Male
Middle Aged
Migraine Disorders / pathology*
Neck Muscles / blood supply*,  innervation*
Nerve Compression Syndromes / pathology*
Reference Values
Scalp / blood supply*,  innervation*
Spinal Nerves / pathology*
Comments/Corrections
Comment In:
Plast Reconstr Surg. 2012 Feb;129(2):353e-354e   [PMID:  22286450 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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