GREATER OCCIPITAL NERVE-INJECTION COMPLICATIONS

SUMMARY

1. Vascularity & proximity to the artery increases the incidence of post-block ecchymosis & hematoma formation.

2. This technique can be safely performed in the presence of anticoagulation with a 25- or 27-gauge needle, albeit at increased risk of hematoma.

3. Application of cold packs for 20-minute periods after the block decreases the amount of post- procedure pain and bleeding.

4. Avoid inadvertent needle placement into the foramen magnum because subarachnoid administration of LA in this region will result in total spinal anesthesia.

5. The most common reason that the nerve block fails is that the headache syndrome being treated has been misdiagnosed as greater occipital neuralgia.

Reference(s)

Furman, Michael B., and Leland Berkwits. Atlas of Image-Guided Spinal Procedures. Elsevier, Inc, 2017.
Horowitz AL. MRI Physics for Physicians. Springer Science & Business Media. (1989) ISBN:1468403338.
Mangrum W, Christianson K, Duncan S et-al. Duke Review of MRI Principles. Mosby. (2012) ISBN:1455700843.