Preoperative visualization of the greater occipital nerve with magnetic resonance imaging in candidates for occipital nerve decompression for headaches.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
02 07 2024
Historique:
received: 28 03 2024
accepted: 19 06 2024
medline: 3 7 2024
pubmed: 3 7 2024
entrez: 2 7 2024
Statut: epublish

Résumé

Occipital nerve decompression is effective in reducing headache symptoms in select patients with migraine and occipital neuralgia. Eligibility for surgery relies on subjective symptoms and responses to nerve blocks and Onabotulinum toxin A (Botox) injections. No validated objective method exists for detecting occipital headache pathologies. The purpose of the study is to explore the potential of high-resolution Magnetic Resolution Imaging (MRI) in identifying greater occipital nerve (GON) pathologies in chronic headache patients. The MRI protocol included three sequences targeting fat-suppressed fluid-sensitive T2-weighted signals. Visualization of the GON involved generating 2-D image slices with sequential rotation to track the nerve course. Twelve patients underwent pre-surgical MRI assessment. MRI identified four main pathologies that were validated against intra-operative examination: GON entanglement by the occipital artery, increased nerve thickness and hyperintensity suggesting inflammation compared to the non-symptomatic contralateral side, early GON branching with rejoining at a distal point, and a connection between the GON and the lesser occipital nerve. MRI possesses the ability to visualize the GON and identify suspected trigger points associated with headache symptoms. This case series highlights MRI's potential to provide objective evidence of nerve pathology. Further research is warranted to establish MRI as a gold standard for diagnosing extracranial contributors in headaches.

Identifiants

pubmed: 38956162
doi: 10.1038/s41598-024-65334-4
pii: 10.1038/s41598-024-65334-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

15248

Subventions

Organisme : Vanderbilt Institute for Clinical and Translational Research
ID : VR60350
Organisme : Plastic Surgery Foundation
ID : 941171

Informations de copyright

© 2024. The Author(s).

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Auteurs

Mariam Saad (M)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.

Isaac V Manzanera Esteve (IV)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.

Adam G Evans (AG)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.

Huseyin Karagoz (H)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.

Tigran Kesayan (T)

Department of Anesthesiology, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.

Krista Brooks-Horrar (K)

Department of Neurology, Tennessee Valley Healthcare System, Nashville, TN, 37212, USA.

Saikat Sengupta (S)

Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.

Ryan Robison (R)

Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
Philips Healthcare, Nashville, TN, 37219, USA.

Brian Johnson (B)

Philips Healthcare, Nashville, TN, 37219, USA.
University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.

Richard Dortch (R)

Barrow Neurological Institute, Phoenix, AZ, 85013, USA.

Wesley P Thayer (WP)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.

Patrick Assi (P)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.

Lisa Gfrerer (L)

Division of Plastic and Reconstructive Surgery, Weill Cornell, New York, NY, 10065, USA.

Salam Kassis (S)

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN, 37232, USA. salam.kassis@vumc.org.

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