The greater occipital nerve is the primary sensory supply to the posterior scalp and the most common target for occipital neuralgia treatment. It pierces the semispinalis capitis muscle near the occipital protuberance — compression at this muscular entry point produces occipital neuralgia with posterior head pain radiating over the vertex to the orbit. GON block at the occipital protuberance is one of the most commonly performed peripheral nerve blocks.
| Origin | Medial branch of the dorsal ramus of C2 |
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GON block (1-2 mL corticosteroid + local anaesthetic at the medial third of the superior nuchal line, 2 cm lateral to the occipital protuberance) provides diagnostic confirmation of cervicogenic headache and therapeutic relief. Pulsed radiofrequency of the GON and C2 dorsal root ganglion provides longer-lasting relief for refractory occipital neuralgia. Occipital nerve stimulation with implanted electrodes is the last-resort treatment.
GON compression or irritation producing posterior head shooting pain managed with GON block, pulsed RF, or occipital nerve stimulation.
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