2018 AANS Annual Scientific Meeting-553. Sports-Related Concussions and Resulting Occipital Headaches: The Role of Posterior Scalp Nerve Decompression

553. Sports-Related Concussions and Resulting Occipital Headaches: The Role of Posterior Scalp Nerve Decompression

Video Transcription

Video Summary

Dr. Rajiv Iyer, a sixth-year neurosurgery resident at Johns Hopkins, discusses the role of posterior scalp nerve decompression in sports-related concussions and resulting occipital headaches. He highlights that brain injuries in the pediatric population are common, leading to post-concussion syndrome and persistent post-concussive headaches. Dr. Iyer explains the involvement of the trigemino-cervical complex and the convergence of pathways causing cervicogenic headaches. The treatment for post-concussion headaches includes lifestyle modifications, medications, and procedures like occipital nerve blocks. Dr. Iyer's retrospective study on athletes under 21 years old with medically refractory headaches found that surgical interventions, such as greater occipital nerve neuralysis and lesser and dorsal occipital nerve transection, significantly improved visual analog scores and reduced the use of headache medications. The majority of patients returned to their sport, and none experienced wound complications. However, further research is needed to determine the most appropriate role for these interventions.

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Rajiv Iyer, MD

Keywords

neurosurgery

occipital headaches

post-concussion syndrome

surgical interventions

headache medications