Complications of Occipital Nerve Block and Radiofrequency Lesioning

Abstract

Occipital nerve blocks can be performed for both diagnostic and therapeutic purposes in several pain syndromes. As the occipital nerve is superficial, it may be performed with a high success rate even with blind landmark-based techniques. A suboccipital compartment block especially requires the utmost attention in terms of serious complications even if performed with the help of fluoroscopy or ultrasound. Due to significant phenotypic overlap, it may be clinically difficult to distinguish occipital neuralgia and cervicogenic headache from primary headache disorders such as migraine or tension headache. Pulsed radiofrequency and continuous radiofrequency ablation have been described in the current literature for great occipital nerve ablation. Infection and bleeding are potential complications of any percutaneous procedure. An anaphylactic reaction to local anesthetic, a toxic reaction after intra-arterial injection of local anesthetic, a major cardiovascular event or the subarachnoid injection of local anesthetic may have triggered unconsciousness.