TY - JOUR
T1 - Teaching NeuroImages
T2 - Greater occipital nerve injection: A cautionary tale
AU - Wei, Diana Y.
AU - Connor, Steve
AU - Goadsby, Peter J.
PY - 2019/2/12
Y1 - 2019/2/12
N2 - A 29-year-old man with medically refractory right-sided chronic cluster headache presented with increased attack frequency. As a bridging therapy, we considered a greater occipital nerve (GON) injection with corticosteroids and local anesthetic. Delving through his childhood medical records, it came to light he had an incidental right cerebellopontine angle dermoid excised. He could not recall the details of this; therefore, plain skull X-ray (figure 1) and head CT (figure 2) were performed. Neuroimaging is required before proceeding with GON injection if there is any suggestion of past neurosurgical intervention. There is a risk of causing loss of consciousness with GON injections into nonintact skull. 1,2
AB - A 29-year-old man with medically refractory right-sided chronic cluster headache presented with increased attack frequency. As a bridging therapy, we considered a greater occipital nerve (GON) injection with corticosteroids and local anesthetic. Delving through his childhood medical records, it came to light he had an incidental right cerebellopontine angle dermoid excised. He could not recall the details of this; therefore, plain skull X-ray (figure 1) and head CT (figure 2) were performed. Neuroimaging is required before proceeding with GON injection if there is any suggestion of past neurosurgical intervention. There is a risk of causing loss of consciousness with GON injections into nonintact skull. 1,2
UR - http://www.scopus.com/inward/record.url?scp=85061392085&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000006929
DO - 10.1212/WNL.0000000000006929
M3 - Comment/debate
C2 - 30745452
AN - SCOPUS:85061392085
SN - 0028-3878
VL - 92
SP - e746-e747
JO - Neurology
JF - Neurology
IS - 7
ER -