The occipital artery is the primary blood supply to the posterior scalp and upper posterior neck muscles, anastomosing extensively with the superficial temporal artery anteriorly and the vertebral artery posteriorly. Its reliable pedicle emerging from below the posterior neck is used for occipital artery flaps in scalp and posterior neck reconstruction. Greater occipital nerve block injections are performed near the occipital artery emergence point.
| Origin | Posterior surface of the external carotid artery |
|---|---|
| Course | Runs backward along the lower border of the posterior belly of digastric, deep to sternocleidomastoid, grooves the mastoid process, and pierces the fascia between the attachments of sternocleidomastoid and trapezius to reach the back of the scalp |
| Branches |
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Near the superior nuchal line the greater occipital nerve runs just medial to the occipital artery, so the palpable arterial pulse guides occipital nerve blocks for occipital neuralgia and headache, injecting medial to the artery while avoiding it. The artery is the pedicle for occipital scalp flaps and is used as a donor artery in some posterior circulation bypass operations. Its meningeal and mastoid branches can feed dural arteriovenous fistulae of the posterior fossa. Giant cell arteritis can involve the occipital artery and cause posterior scalp tenderness alongside temporal symptoms.
Inflammation of the artery in giant cell arteritis causes posterior scalp pain and tenderness that may accompany temporal artery symptoms and needs urgent corticosteroid treatment.
Injecting at the nerve's emergence without locating the artery can puncture it, causing a scalp haematoma or intravascular injection; palpating or scanning the pulse and injecting medial to it reduces the risk.
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