Postoperative headache following acoustic neuroma resection: occipital nerve injuries are associated with a treatable occipital neuralgia
Headache: The Journal of Head and Face Pain,

Ducic I et al. – In contradistinction to previous reports, we have identified a subset of patients in whom the syndrome of postoperative headache appears directly related to the presence of occipital nerve injuries. In patients with postoperative headache meeting diagnostic criteria for occipital neuralgia, occipital nerve excision appears to provide relief of the headache syndrome and meaningful improvement in quality of life. Further studies are needed to confirm these results and to determine whether occipital nerve injury may present as headache types other than occipital neuralgia. These findings suggest that patients presenting with chronic postoperative headache should be screened for the presence of surgically treatable occipital nerve injuries.

Methods
  • Records were reviewed to identify patients who had undergone surgical excision of the greater and lesser occipital nerves for refractory chronic postoperative headache following acoustic neuroma resection.
  • Primary outcomes examined were change in migraine headache index, change in number of pain medications used, continued use of narcotics, patient satisfaction, and change in quality of life.
  • Follow–up was in clinic and via telephone interview.

Results
  • Seven patients underwent excision of the greater and lesser occipital nerves.
  • All met diagnostic criteria for occipital neuralgia and failed conservative management.
  • Six of 7 patients experienced pain reduction of greater than 80% on the migraine index.
  • Average pain medication use decreased from 6 to 2 per patient; 3 of 5 patients achieved independence from narcotics.
  • Six patients experienced 80% or greater improvement in quality of life at an average follow–up of 32 months.
  • There was one treatment failure.
  • Occipital nerve neuroma or nerve entrapment was identified during surgery in all cases where treatment was successful but not in the treatment failure.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Family Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Family Medicine Articles

1 A comparison of different oral therapies versus no treatment for erectile dysfunction in 196 radical nerve-sparing radical prostatectomy patients International Journal of Impotence Research: The Journal of Sexual Medicine, August 12, 2014    Clinical Article

2 Plasma tocopherols and risk of prostate cancer in the selenium and vitamin E cancer prevention trial (SELECT) Cancer Prevention Research, August 25, 2014    Clinical Article

3 Adjuvant radiotherapy versus wait-and-see after radical prostatectomy: 10-year follow-up of the ARO 96–02/AUO AP 09/95 Trial Full Text European Urology, July 18, 2014    Free full text    Clinical Article

4 Metformin in chemotherapy-naive castration-resistant prostate cancer: A multicenter phase 2 trial (SAKK 08/09) Full Text European Urology, August 15, 2014    Free full text    Clinical Article

5 Obesity is a risk factor for significant carotid atherosclerosis in patients aged 39 to 55 years Angiology, July 18, 2014    Evidence Based Medicine    Clinical Article

6 Management of prostate cancer in older patients: updated recommendations of a working group of the International Society of Geriatric Oncology The Lancet Oncology, July 30, 2014    Clinical Article

7 Circumcision plus antibiotic, anti-inflammatory, and α-blocker therapy for the treatment for chronic prostatitis/chronic pelvic pain syndrome: A prospective, randomized, multicenter trial World Journal of Urology, July 16, 2014    Clinical Article

8 Effect of caffeine on exercise capacity and function in prostate cancer survivors Medicine and Science in Sports and Exercise, July 9, 2014    Clinical Article

9 Urinating standing versus sitting: Position is of influence in men with prostate enlargement. A systematic review and meta-analysis PLOS ONE, August 1, 2014    Evidence Based Medicine    Review Article
Exclusive Author Commentary

10 Curcumin for the treatment of major depression: A randomised, double-blind, placebo controlled study Journal of Affective Disorders, July 16, 2014    Clinical Article

11 National trends in the management of low- and intermediate-risk prostate cancer in the United States The Journal of Urology, August 13, 2014    Clinical Article

12 Changes in circulating leptin levels during acute stress and associations with craving in abstinent smokers: A preliminary investigation Psychoneuroendocrinology, June 20, 2014    Clinical Article

13 Screening for prostate cancer in the US? Reduce the harms and keep the benefit International Journal of Cancer, August 15, 2014    Clinical Article

14 Effects of medical therapy or surgery on prostatic and bladder resistive indices in patients with benign prostatic hyperplasia Urologia Internationalis, August 19, 2014    Clinical Article

15 Management options for the treatment of benign prostatic hyperplasia with or without erectile dysfunction: a focus on tadalafil and patient considerations Full Text International Journal of General Medicine, August 12, 2014    Free full text    Review Article

16 Effects of tadalafil once daily or on demand versus placebo on time to recovery of erectile function in patients after bilateral nerve-sparing radical prostatectomy World Journal of Urology, August 27, 2014    Clinical Article

17 Cost-effectiveness of magnetic resonance (MR) imaging and MR-guided targeted biopsy versus systematic transrectal ultrasound–guided biopsy in diagnosing prostate cancer: A modelling study from a health care perspective Full Text European Urology, August 18, 2014    Free full text    Clinical Article

18 Radiation-induced secondary malignancy in prostate cancer: A systematic review and meta-analysis Urologia Internationalis, August 19, 2014    Evidence Based Medicine    Review Article

19 Efficacy of vilazodone on anxiety symptoms in patients with major depressive disorder International Clinical Psychopharmacology, July 2, 2014    Clinical Article

20 A population-based nested case-control study: the use of 5-alpha-reductase inhibitors and the increased risk of osteoporosis diagnosis in patients with benign prostate hyperplasia Clinical Endocrinology, August 28, 2014    Clinical Article

Indexed Journals in Family Medicine: American Family Physician, Archives of Family Med, Annals of Family Medmore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close