D152. Onset of Occipital Neuralgia Following Head and Neck Trauma

PURPOSE: This study aims to determine the onset of ON following trauma and the types of traumas that may predispose to ON. METHODS: Patients with ON (n=204) were evaluated for history of head or neck injury, timing of head pain following injury, and mechanism of injury. Postoperative outcomes were collected for patients who underwent nerve decompression surgery (n=30). RESULTS: 104 patients (51%) reported a history of head and/or neck injury; 54 (52%) reported their head pain started after injury. Most patients (n=25, 46.3%) reported their pain started on the same day of injury, 10 patients (18.5%) within one week, 4 patients (7.4%) within one month, 3 patients (5.5%) within 6 months, 3 patients (5.5%) within one year, and 9 patients (16.7%) reported “other” onset. Mechanism of injury included whiplash (n=70, 67.3%), direct strike to head (n=49, 47.1%), direct strike to neck (n=7, 6.7%), direct strike to head and neck (n=26, 25%), and other (n=7, 6.7%). Following nerve decompression, patients with a past medical history of trauma experienced a significant reduction in average pain intensity, frequency, and duration (p<0.001). CONCLUSION: Most patients with ON and a history of trauma, most commonly whiplash, reported their pain started on the same day of injury. Surgical decompression is an appropriate treatment for pain relief in ON patients who have a history of head and/or neck trauma.