The anatomical descriptive pattern of the greater occipital nerve in identified Brazilian cadavers and its clinical implications for scalp anesthesia and migraine treatment

Abstract

Among the measures instituted for the treatment of migraine, the greater occipital nerve (GON) block is described as being an effective, safe, easy to perform and useful technique for the treatment of this condition. However, the measures used to block the GON vary, and there is a lack of information data about the Brazilian population. Therefore, a morphometric study was carried out on 22 identified cadavers, in which the distances were measured on both sides of the following anatomical points: EOP, MP, and GON with anatomical references of the nuchal ligament, Trapezius muscle aponeurosis and MSEC perforation. ANOVA was used for statistical analysis, with Tukey post-hoc and Eta Square (η2) for effect size. Significance was adopted when p ≤ 0.05. The ANOVA found a significant effect of ethnicity regarding the distances in the GON measurements of the EOP on the line between the EOP and MP – Left antimere; subsequent univariate analysis showed differences between white and oriental ethnicity (pTukey= 0.02); horizontal distance of the GON about the nuchal line – Right antimere; Subsequent univariate analysis showed differences between white and brown ethnicities (pTukey= 0.02); horizontal distance of the GON about the nuchal line – Left antimere. Subsequent univariate analyses showed differences between white and brown ethnicities (pTukey= 0.02). There are morphometric differences in some anatomical points used to block the GON when comparing the two antimeres, as well as in white, brown, and oriental ethnicities.