Arquivos de Neuro-Psiquiatria
Print version ISSN 0004-282X
On-line version ISSN 1678-4227
VINCENT, MAURICE B.; LUNA, RENATO A.; SCANDIUZZI, DENISE and NOVIS, SÉRGIO A. P. Greater occipital nerve blockade in cervicogenic headache. Arq. Neuro-Psiquiatr. [online]. 1998, vol.56, n.4, pp.720-725. ISSN 0004-282X. http://dx.doi.org/10.1590/S0004-282X1998000500004.
Cervicocogenic headache (CeH) is a relatively common disorder. Although no ideal treatment is available so far, blockades in different structures and nerves may be temporarily effective. We studied the effects of 1-2 mL 0.5% bupivacaine injection at the ipsilateral greater occipital nerve (GON) in 41 CeH patients. The pain is significantly reduced both immediately and as long as 7 days after the blockade. The improvement is less marked during the first two days, a phenomenon we called "tilde pattern". GON blockades may reduce the pool of exaggerated sensory input and antagonize a putative "wind-up-like effect" which may explain the headache improvement.
Keywords : anaesthetic blockade; bupivacaine; cervicogenic headache; greater occipital nerve.