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Case Reports
. 2018 Feb 27;2(1):57-61.
doi: 10.1080/24740527.2017.1360725. eCollection 2018.

Occipital osteomylelitis and epidural abscess after occipital nerve block: A case report

Sean D Christie  1 , Nelofar Kureshi  1 , Ian Beauprie  2 , Renn O Holness  3
Affiliations
Case Reports

Occipital osteomylelitis and epidural abscess after occipital nerve block: A case report

Sean D Christie et al. Can J Pain. .

Abstract
in English, French

Occipital neuralgia is a paroxysmal jabbing pain in the distribution of the greater or lesser occipital nerves accompanied by diminished sensation in the affected area. Occipital nerve block is a common diagnostic and therapeutic tool used in the course of occipital neuralgia and is considered a safe treatment with few localized adverse events. Occipital nerve block is also indicated for cervicogenic and cluster headache and is often used as a rescue treatment for headaches not responding to conventional therapies. We describe a case of epidural abscess formation 16 days following occipital nerve block in a patient with no underlying medical conditions. This case report emphasizes the importance of strict aseptic technique to reduce infection rates in patients undergoing this procedure, despite the overall safety of occipital nerve block. Clinicians must remain aware of acute and late complications arising postprocedure for the safe practice of this technique.

La névralgie occipitale est une douleur lancinante paroxystique dans la distribution des nerfs du grand ou du petit occipital qui s’accompagne d’une diminution des sensations dans la zone affectée. Le bloc du nerf occipital, un outil diagnostique et thérapeutique communément utilisé dans le cadre d’une névralgie occipitale, est considéré comme un traitement sécuritaire qui n’entraine que peu d’effets indésirables localisés. Le bloc du nerf occipital, également indiqué pour traiter la céphalée cervicogénique et la céphalée vasculaire de Horton, est souvent utilisé en tant que traitement de secours pour les céphalées qui ne répondent pas aux thérapies conventionnelles. Nous décrivons un cas de formation d’un abcès épidural 16 jours après le bloc du nerf occipital chez un patient sans affection médicale sous-jacente. L’étude de cas met l’accent sur l’importance d’une stricte conformité aux techniques d’asepsie afin de réduire les taux d’infection chez les patients soumis à cette procédure, malgré le caractère sécuritaire du bloc du nerf occipital. Les cliniciens doivent demeurer vigilants quant aux complications aigues et tardives qui peuvent survenir après la procédure afin d’appliquer cette technique de manière sécuritaire.

Keywords: epidural abscess; occipital nerve block; occipital neuralgia.

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Figures

Figure 1a.
Figure 1a.
CT scan showing soft tissue swelling suggestive of epidural abscess of left posterior fossa.
Figure 1b.
Figure 1b.
CT scan showing mottled appearance of left occipital bone, consistent with osteomyelitis.
Figure 2a.
Figure 2a.
MRI axial T2 image revealing high signal intensity within left suboccipital soft tissue and epidural space.
Figure 2b.
Figure 2b.
T1 axial unenhanced image showing left suboccipital and epidural low signal intensity suggestive of soft tissue swelling.
Figure 2c.
Figure 2c.
TI axial post gadolinium image demonstrating a ring-enhancing lesion of left suboccipital soft tissue and posterior fossa epidural space consistent with abscess.
See this image and copyright information in PMC

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References

    1. Beruto LJ, Ramos MM.. Decades de med y cirug pract. Madrid. 18213:145–169.
    1. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629–808. doi:10.1177/0333102413485658. - DOI - PubMed
    1. Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. the cervicogenic headache international study group. Headache. 1998;38(6):442–445. doi:10.1046/j.1526-4610.1998.3806442.x. - DOI - PubMed
    1. Yi X, Cook AJ, Hamill-Ruth RJ, Rowlingson JC. Cervicogenic headache in patients with presumed migraine: missed diagnosis or misdiagnosis? J Pain. 2005;6(10):700–703. doi:10.1016/j.jpain.2005.04.005. - DOI - PubMed
    1. Tobin J, Flitman S. Occipital nerve blocks: when and what to inject? Headache. 2009;49(10):1521–1533. doi:10.1111/j.1526-4610.2009.01493.x. - DOI - PubMed

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