TITLE:
Ultrasound-Guided Greater Occipital Nerve Hydrodissection for Treatment of Cervicogenic Headache: A Case Report
AUTHORS:
Paul J. Ryan, Dominic C. Harmon
KEYWORDS:
Cervicogenic Headache, Neck Pain, Occipital Nerve, Hydrodissection, Ultrasound
JOURNAL NAME:
Pain Studies and Treatment,
Vol.11 No.1,
January
31,
2023
ABSTRACT: We describe an innovative technique of ultrasound-guided greater occipital
nerve (GON) hydrodissection for treatment of cervicogenic headache and occipital
neuralgia. A 35-year-old female presented to the pain clinic with severe
chronic cervicogenic headache impacting her sleep, work and activities of daily
living. Conservative management had failed to adequately resolve her pain.
Ultrasound-guided suboccipital hydrodissection of the greater occipital nerve
was performed with the patient in the prone position. After skin sterilization,
the linear ultrasound transducer was oriented in a transverse orientation at
the level of the C2-C3 vertebrae. The needle was advanced from medial to
lateral “in-plane” under direct ultrasound visualization, until the needle was
positioned at the C2 lamina. After confirming the needle tip position, 10 ml of
hydrodissection fluid was injected with good visualization of distribution of
the solution. The patient described immediate and significant improvement in
her symptoms. She reported a sustained decrease in pain scores when followed up
in the pain clinic at six and twelve weeks respectively. To the best of our
knowledge this is the first application of ultrasound-guided hydrodissection of
the GON for cervicogenic headache. It offers a novel, safe and effective
technique to aid in the diagnosis and treatment of a common pain condition.