The Effects of Greater Occipital Nerve Block in Patients With Migraine and Cervicogenic Headache: A Retrospective Clinical Study
ACTA NEUROLOGICA SCANDINAVICA, cilt.2026, sa.1, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 2026 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1155/ane/1553924
- Dergi Adı: ACTA NEUROLOGICA SCANDINAVICA
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Psychology & Behavioral Sciences Collection (EBSCO)
- İstanbul Üniversitesi Adresli: Evet
Özet
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.