This area is located in the back of the head where Greater Occipital nerve passes through Semispinalis muscle. Migraine surgery for this site is done by an incision in back of the scalp in lower part of the hairline. The Greater Occipital Nerve can be compressed in multiple locations like fascia, muscle, artery or trapezius aponeurosis.
Occipital trigger point; showing the greater and lesser occipital nerves bilaterally and greater occipital artery
Incision used for occipital trigger point, the entire incision is within the hair bearing area.
Occipital trigger point; shows exposure of the Semispinalis muscle and Greater Occipital nerve after removal of the Trapezius fasci on top of it, slightly lateral to the midline occipital artery crosses the nerve.
Occipital trigger point: the goal of the surgery is to decompress the nerve in multiple levels like muscle, Trapezius fascia and artery
Occipital trigger point: closure after surgery; the entire scar in in the hair bearing area.
Minor trigger point: These trigger points are uncommon, usually people have tenderness over these areas. surgery is done by a small incision over the tenderness and artery is separated from nerve and transected, in some occasions we can find a fascial band or muscle compressing the nerve and pressure point is released without nerve cut.