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Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The cervical nerves also provide sensory innervation for two true (i.e., branchiomeric) head muscles via the cervical plexus: nerve C2 and C3 to the sternocleidomastoid and nerves C3 and C4 to the trapezius. The cervical nerves also provide cutaneous innervation to the skin of the neck and posterior region of the head. The lesser occipital nerve, great auricular nerve, transverse cervical nerve, and the supraclavicular nerve are branches of the cervical plexus that enter the superficial fascia posteriorly to the sternocleidomastoid to supply distinct areas: the scalp, the skin of the lower part of the ear and angle of mandible and mastoid process, the skin of the anterior triangle of the neck, and the skin of the superior region of the shoulder, respectively. In contrast, the dorsal rami of the cervical spinal nerves mainly pierce the trapezius and go superficially to innervate the back of the head and neck. One of these nerves is the greater occipital nerve, hence the name “lesser occipital nerve” for the nerve coming from the cervical plexus.
Evaluation of the Skull Base Patient
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Jeyanthi Kulasegarah, Richard M. Irving
Otalgia can be classified into otogenic otalgia, which originates from external, middle and inner ear, and referred otalgia, which arises from pathology outside the ear. Referred otalgia is associated with: (i) auriculotemporal nerve (cranial nerve V3); (ii) posterior auricular nerve (cranial nerve VII); (iii) Jacobson’s nerve (cranial nerve IX); (iv) Arnold’s nerve (cranial nerve X); (v) greater auricular nerve (C2); and (vi) lesser occipital nerve (C3). Severe otalgia is a cardinal symptom of intratemporal malignancy, particularly carcinoma of the external auditory canal or middle ear.7
Postconcussive syndrome
Published in Brian Sindelar, Julian E. Bailes, Sports-Related Concussion, 2017
Brian Sindelar, Julian E. Bailes
A specific type of cervicogenic headache due to peripheral nerve irritation is occipital neuralgia. This is due to either direct neck trauma or a whiplash injury that causes injury to the greater or lesser occipital nerves.163 Pain is severe and shooting along the craniocervical junction may be reproduced with movement of the head or palpation of the greater occipital nerve (2 cm lateral and 2 cm inferior to the external occipital protuberance) and can also be associated with eye pain and tinnitus.163,196 Initial conservative measures include massage therapy, nonsteroidal muscle relaxers, gabapentin, or tricyclic antidepressants.163 Athletes with refractory symptoms should be referred to a neurologist or pain management specialist for pharmacological management, consideration for local injections, and possible surgical intervention if more noninvasive measures are unsuccessful.163,181,186,197
Occipital osteomylelitis and epidural abscess after occipital nerve block: A case report
Published in Canadian Journal of Pain, 2018
Sean D. Christie, Nelofar Kureshi, Ian Beauprie, Renn O. Holness
Occipital nerve block is a common diagnostic and therapeutic tool used in the course of occipital neuralgia, and injections are commonly performed by both family physicians and specialists. Ultrasound-guided approaches are superior to landmark techniques for favorable outcome with occipital nerve block.11 The greater occipital nerve (GON) provides cutaneous innervation to the posterior scalp, whereas the lesser occipital nerve supplies scalp sensation lateral to the GON to the posterior auricle. In patients with occipital neuralgia, the GON may be blocked alone or with the lesser occipital nerve for peripheral nerve block. Local anesthetics including lidocaine, mepivacaine, and bupivacaine may be injected as monotherapy or as combinations. Corticosteroids may be added for patients who do not respond to infiltration with local anesthetic only.
Cervical myelitis presenting as occipital neuralgia
Published in International Journal of Neuroscience, 2018
Occipital neuralgia refers to a unilateral headache associated with the greater occipital nerve, lesser occipital nerve or third occipital nerve [1]. Although occipital neuralgia is often idiopathic, it can be induced by external injury, nerve compression or nerve pathway inflammation [2,3]. We describe an elderly patient with episodic occipital neuralgia for 10 years, who was eventually diagnosed with cervical myelitis presenting as occipital neuralgia.
Scalp block for awake craniotomy: Lidocaine-bupivacaine versus lidocaine-bupivacaine with adjuvants
Published in Egyptian Journal of Anaesthesia, 2020
Yasser M. Nasr, Salwa H. Waly, Ahmed A. Morsy
Circumferential scalp block was performed using 3-5 mL of LA for each of the branches responsible for sensory supply of the forehead and scalp including supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, greater occipital, and lesser occipital nerves (Figure 1) as follows: