Purpose:

To verify the anatomy of the greater occipital nerve, possible points of entrapment or irritation, and external landmarks useful to access this nerve for the treatment of migraine headaches

Methods and Materials:

Nineteen fresh cadaver heads were dissected (38 greater occipital nerves) to evaluate the course of the greater occipital nerve. Measurements were taken relative to the occipital protuberance and the midline. Mean and standard deviation were computed.

Results:

The only consistent transmuscular course was in the region of the semispinalis. This muscle investment may serve as a point of compression, entrapment, or irritation. Based on our measurements, the GON may be accessed in a region 1.5 cm in diameter, centered 3 cm below the occipital protuberance and 1.5 cm from the midline. Ongoing studies will determine the specific utility of this information for patients suffering from migraine headaches.

Training Program Director: Rod J. Rohrich, M.D.