Hydrodissection of Greater Occipital Nerve for Migraine Treatment: A Case Report

Peripheral nerve hydrodissection is a novel technique that can be applied in the treatment of neuropathic pain and musculoskeletal medicine. However, hydrodissection for migraine treatment has not been previously reported. We present the case of an 85-year-old female with recurrent migraine. Despite extensive conservative therapies she continued to experience recurrent migraine. The patient underwent ultrasound-guided bilateral greater occipital nerve hydrodissection as a targeted approach to address perineural inflammation or nerve entrapment of the Greater Occipital Nerve. Hydrodissection with 10 mL of 5% dextrose solution of the greater occipital nerve was performed at the level of C2 vertebrae in a theatre setting. Following the procedure, the patient experienced improvement in migraine, with sustained improvement over three months, at follow-up. Functional outcomes, including daily activities, improved substantially. No complications were reported. This is the first case to support the potential role of dextrose hydrodissection as a safe, minimally invasive treatment option for recurrent migraine. These results warrant further investigation of this technique in the management of recurrent migraine.