The Effects of Greater Occipital Nerve Block in Patients With Migraine and Cervicogenic Headache: A Retrospective Clinical Study

IF 1.1 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2026-09-15 DOI:10.1155/ane/1553924

Ebru Alanbay Yagci, Senay Yildiz, Halil Cetingok, Gul Koknel Talu

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引用次数: 0

Abstract

Objectives

Greater occipital nerve (GON) block is used in both migraine and cervicogenic headache (CGH), but comparative clinical data using a standardized ultrasound-guided proximal technique remain limited. This study evaluated short- to midterm clinical outcomes after GON block in patients with episodic migraine without aura and CGH.

Methods

This retrospective observational study included patients aged 18–65 years who underwent ultrasound-guided proximal GON block between January 2021 and September 2025 and completed at least 3 months of follow-up. Patients were classified as having episodic migraine without aura or CGH according to ICHD-3 criteria. Outcomes included Visual Analog Scale (VAS) pain scores, Headache Disability Index (HDI), monthly headache attack frequency, monthly acute headache medication consumption, patient satisfaction, and procedure-related adverse events. Exploratory subgroup analyses compared single versus three-session GON block protocols in both diagnostic groups and unilateral versus bilateral applications in the migraine subgroup. In the CGH group, GON block was performed unilaterally on the symptomatic side.

Results

A total of 213 patients were included, comprising 171 patients with episodic migraine without aura and 42 with CGH. Both groups showed significant reductions in VAS scores at 1 and 3 months compared with baseline (all p < 0.001), with no significant between-group differences at baseline, 1 month, or 3 months. In the migraine subgroup, the triple GON block protocol was associated with lower VAS scores than the single protocol at 1 month (3.9 ± 1.3 vs. 4.6 ± 1.4, p = 0.01; Cohen′s d = 0.52) and 3 months (4.4 ± 1.7 vs. 5.1 ± 1.8, p = 0.02; Cohen′s d = 0.39). No significant differences were observed between unilateral and bilateral applications in migraine or between single and triple protocols in CGH. HDI scores, monthly headache attack frequency, and monthly acute medication consumption improved significantly in both diagnostic groups. No serious or persistent procedure-related complications were recorded.

Conclusions

Ultrasound-guided proximal GON block was associated with significant improvements in pain intensity and headache-related outcomes in both episodic migraine without aura and CGH, with improvements remaining evident at 3 months. Triple GON block may provide additional short- to midterm pain reduction in selected migraine patients; however, these exploratory findings require confirmation in prospective randomized sham-controlled studies.

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枕大神经阻滞治疗偏头痛和颈源性头痛的回顾性临床研究

枕大神经（GON）阻滞用于偏头痛和颈源性头痛（CGH），但使用标准化超声引导近端技术的比较临床数据仍然有限。这项研究评估了没有先兆和CGH的发作性偏头痛患者在接受神经激素阻断后的短期到中期临床结果。方法本回顾性观察研究纳入了年龄在18-65岁之间，于2021年1月至2025年9月期间接受超声引导下近端神经根阻滞的患者，并完成了至少3个月的随访。根据ICHD-3标准，将患者分为无先兆发作性偏头痛或CGH。结果包括视觉模拟量表（VAS）疼痛评分、头痛残疾指数（HDI）、每月头痛发作频率、每月急性头痛药物用量、患者满意度和手术相关不良事件。探索性亚组分析比较了两种诊断组的单次和三次静脉曲张阻断方案以及偏头痛亚组的单侧和双侧应用。在CGH组中，在症状侧单侧进行GON阻滞。结果共纳入213例患者，其中无先兆发作性偏头痛171例，CGH 42例。两组在1个月和3个月时的VAS评分与基线相比均有显著降低（均p <； 0.001），在基线、1个月或3个月时组间无显著差异。在偏头痛亚组中，在1个月（3.9±1.3比4.6±1.4,p = 0.01; Cohen’s d = 0.52）和3个月（4.4±1.7比5.1±1.8,p = 0.02; Cohen’s d = 0.39）时，三次GON阻断方案的VAS评分低于单一方案。在偏头痛的单侧和双侧应用或CGH的单一和三重方案之间没有观察到显著差异。两个诊断组的HDI评分、每月头痛发作频率和每月急性用药均有显著改善。没有记录严重或持续的手术相关并发症。超声引导下近端骨甾体受体阻滞与无先兆发作性偏头痛和CGH患者疼痛强度和头痛相关结局的显著改善相关，在3个月时仍有明显改善。三重神经甾体受体阻滞可在选定的偏头痛患者中提供额外的短期到中期疼痛减轻；然而，这些探索性发现需要在前瞻性随机假对照研究中得到证实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.