Suggest Treatment For Pain At The Base Of My Skull Radiating To Right Side And Crown Of My Head

Posted on Sun, 1 Mar 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 1 Mar 2015 Answered on

Mon, 30 Mar 2015 Last reviewed on

Question : I have had three rear-ended car accidents over the past 40 years. Pain at the base of my skull going up the right side of my head and around the crown of my head has been severe for about two years. I have had all kinds of injections; with and without anethes. I was then advised to see a surgeon. August 2014 I had surgery; three vertebras in my neck replaced and two fused. I was told by the surgeon my pain was common and she would be able to completely resolve my pain. The pain is back with the severity it was before surgery. In questioning the surgeon she said NOW that it is caused by C1 vertebra and therefore too much a risk for surgery. Any suggestions or comments?

Answered by Dr. Dr. Erion Spaho (3 hours later)

Brief Answer:
Occipital neuralgia should be considered.

Detailed Answer:
Hi, I have gone through your question and understand your concerns.

In my opinion, occipital neuralgia should be considered as a possible cause of your symptoms.

Occipital neuralgia is caused by compression of cervical nerves that supply back and top of the head.

Its treatment ( if your diagnosis is right) is rarely surgical and not so risky. It mainly consists in nerve block and nerve ablation procedures.

If the C1 vertebra is the reason of your symptoms and not occipital neuralgia, then there are different surgical routes and procedures to fix it and these include anterior transoral route ( too risky), posterior fixation with screws and rods at occipital bone-C1-C2 vertebrae ( not much risky).

I suggest you to discuss with your treating Doctor the possibility of occipital neuralgia as a cause of your symptoms. Its treatment is easy.

Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Erion Spaho (35 hours later)

Thank you very much, Doctor. I greatly appreciate your review and opinion of the cause along with considered treatment.

I will see my pain management doctor later today and will share your kind reply with her. If she has concerns that she states to me, I may need to get back with you regarding what her concerns are.

Again, thank you so much for your advice. XXXXXXX Sykes

Answered by Dr. Dr. Erion Spaho (38 minutes later)

Brief Answer:
You're welcome.

Detailed Answer:
Hi again.
Glad to hear I helped you understand better your condition.
If you have any questions, feel free to ask.
Wishing you good health.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj