Referred Trigeminal Facial Pain from Occipital Neuralgia Occurring Much Earlier than Occipital Neuralgia

Figure 2

Intraoperative photographs during the decompression of the greater occipital nerve (GON). (a) Intraoperative photograph showing severe entrapment of the GON (white arrowheads) by the aponeurotic fibrous attachment of the trapezius (white arrows) at the superior nuchal line. The maximal compression point (black arrow) is seen by lifting the trapezial aponeurotic edge. The inset shows the direction of the photo and the location of the incision. (b) Intraoperative photograph after decompression of the left GON (white arrow heads) with the division of the trapezial aponeurosis (white arrows). Even after decompressing the upper side, the GON was still depressed by the lower fascial aponeurosis (black arrowheads). (c) Intraoperative photograph after complete decompression of the left GON (white arrowheads). Its proximal and distal courses are addressed.

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