Suboccipital Bursa

bursa suboccipitalis

The suboccipital bursa is located between the posterior arch of the atlas and the overlying posterior atlantooccipital membrane and ligamentum nuchae, in the midline immediately below the occiput. It cushions the atlantooccipital junction during head extension and serves as the deepest layer of the suboccipital soft tissue complex. It may communicate with the atlantooccipital joint in some individuals.

Region: Neck

Clinical Relevance

Clinical Notes

Suboccipital bursitis contributes to deep suboccipital pain at the craniovertebral junction, often indistinguishable clinically from atlantooccipital joint synovitis or suboccipital muscle trigger points. It has been implicated in the tenderness produced by posterior decompression of the craniocervical junction. Fluoroscopic or ultrasound-guided injection at the atlantooccipital level can target the bursa and joint simultaneously. It is distinct from the much larger bursa that occasionally develops over C7 in Dowager hump deformity.

Pathology

Common Injuries & Conditions

Suboccipital Bursitis

Inflammation of the suboccipital bursa from direct trauma, sustained forward head posture, or craniocervical hypermobility produces deep aching at the base of the skull aggravated by head extension, often coexisting with atlantooccipital joint synovitis and managed with physiotherapy and targeted injection.