Ipsilateral Limb Extension of Referred Trigeminal Facial Pain due to Greater Occipital Nerve Entrapment: A Case Report

Figure 3

Intraoperative photographs of decompression of the greater occipital nerve (GON) and osteoma removal. (a) GON (white arrows) entrapment at the trapezial tunnel. The GON entrapment is observed by lifting the trapezial aponeurotic edge (black arrows). The inset shows the direction of the image and the location of the incision. The skull reconstruction image in the inset represents the position of the head and skin incision in the surgical field. (b) Complete decompression of the GON (arrows) around the trapezial tunnel. The white circle indicates the location of the osteoma. The GON had no direct contact with the osteoma. (c) Osteoma (white arrow) exposed after retraction of the GON (black arrow). (d) Intraoperative photograph showing the decompressed GON (white arrow) after removal of the osteoma (black arrow). The patient’s left hemiface, posterolateral neck, and shoulder pain, as well as pain in the left extremity, had completely improved by 2 weeks after surgery.