[Greater occipital nerve blockade: trigeminicervical system and clinical applications in primary headaches]. / Büyük oksipital sinir blokaji: Trigeminoservikal sistem ve primer basagrilarindaki klinik uygulamalar.

Studies about greater occipital nerve injection in primary headaches had begun with Michael Anthony and almost all the studies today accept Anthony's studies as reference work. Although more than twenty years passed, there is not enough study about the subject. According to the present data, steroids are apparently effective in both preventive and acute attack therapy in cluster headache. Efficacy in migraine is not dramatic as in cluster headache. Despite the fact that local anesthetics has a role in relieving acute headache, single injection is not suitable in prophylactic treatment. In clinical practice, there is promising data about the usage of the procedure, until the beginning of the effect of principal preventive therapy in cluster headache and during the detoxification process in analgesic induced chronic migraine. Although there are case reports about the relieving acute pain in cluster headache and migraine, there is need for systematized clinical studies.

Extracephalic stabbing pain temporally related to cephalic ones.

A 23-year-old woman consulted with the complaint of short-lasting, severe stabbing headaches and mild-to-moderate degree near-daily migrainous headaches. Further questioning revealed that she also had stabbing pain on both ipsilateral hand and calf. Stabs on the hand were time-locked to cephalic ones and stabs in the calf were alternating with the ones in the hand. Dizziness and scotomas were accompanying symptoms to cephalic ones and paresthesia was the accompanying symptom in the hand. Patient's cephalic and extracephalic stabbing pains responded to indomethacine and daily headaches responded to prophylactic sodium valproate therapy. The stabs were felt in the head; hand and calf are considered as the parts of a whole. Along with its accompanying symptoms, stabbing pain may be the result of complex interactions in central nervous system.