8 - Greater and Lesser Occipital Nerve Block: Radiofrequency Lesioning

Abstract

The greater occipital nerve arises from fibers of the dorsal primary ramus of the second cervical nerve and to a lesser extent from fibers of the third cervical nerve. It supplies the medial portion of the posterior scalp as far anterior as the vertex. The lesser occipital nerve arises from the ventral primary rami of the second and third cervical nerves. The lesser occipital nerve passes superiorly along the posterior border of the sternocleidomastoid muscle, dividing into cutaneous branches that innervate the lateral portion of the posterior scalp and the cranial surface of the pinna of the ear. Radiofrequency lesioning of the occipital nerve block is useful in select patients who have experienced short-term relief with occipital nerve blocks performed using local anesthetic or steroid and have failed to respond to other conservative therapies.