Greater Occipital Nerve Treatment in the Management of Spontaneous Intracranial Hypotension Headache: A Case Report

Background Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in...

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Bibliographic Details
Published in:Headache Vol. 57; no. 6; pp. 952 - 955
Main Authors: Niraj, G., Critchley, Peter, Kodivalasa, Mahesh, Dorgham, Mohammed
Format: Journal Article
Language:English
Published: United States 01.06.2017
Subjects:
Adult
greater occipital nerve block
Headache - diagnostic imaging
Headache - etiology
Headache - therapy
Humans
Intracranial Hypotension - complications
Intracranial Hypotension - diagnostic imaging
Intracranial Hypotension - therapy
Male
Nerve Block
Pulsed Radiofrequency Treatment
spontaneous intracranial hypotension headache
greater occipital nerve block
spontaneous intracranial hypotension headache
pulsed radiofrequency treatment
ISSN:0017-8748, 1526-4610, 1526-4610
Online Access:Get full text
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Summary:Background Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. Methods A 40‐year‐old male presented with a 2‐year history of daily postural headaches having a significant impact on quality of life. Magnetic resonance imaging revealed bilateral convexity subdural collections. Post gadolinium scan revealed pachymeningeal enhancement with reduced pontomesencephalic angle below 50 degrees. The patient was offered an epidural blood patch and greater occipital nerve block with corticosteroids. The patient chose occipital nerve block. Result The patient reported significant short‐term benefit lasting 4 months. Thereafter, the patient underwent pulsed radiofrequency treatment to bilateral greater occipital nerves. He reported significant benefit lasting 10 months. Conclusion Greater occipital nerve treatment may have a role in management of SIHH.
Bibliography:None.
Conflict of Interest
ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ISSN:0017-8748
1526-4610
1526-4610
DOI:10.1111/head.13095