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The Use of Fat Grafting for Chronic Headache of Cervical Origin Treatment

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Atlas of Surgical Therapy for Migraine and Tension-Type Headache

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Abstract

Chronic headache of cervical origin (chronic cervicogenic headache and occipital neuralgia) is characterized by persistent pain due to great occipital nerve entrapment within the trapezoid tunnel, with concurrent myofascial spasm. Symptoms are often impairing, thus influencing everyday activities and decreasing the quality of life. A great number of surgical and nonsurgical options have been proposed even though recurrence rate and failure of the therapy remain considerable. Regenerative surgery might represent in selected cases as an excellent solution especially for recurrent cases as a second-line approach after pharmacological treatment failure. In the present chapter, we report our experience with autologous fat grafting for occipital neuralgia treatment, and we describe the operative technique, outcomes, and future perspectives.

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References

  1. Ashkenazi A. Three common neuralgias. Postgrad Med. 2004;116:16–32.

    Article  Google Scholar 

  2. Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. Lancet Neurol. 2009;8:959–68.

    Article  Google Scholar 

  3. Yi X, Cook AJ, Hamill-Ruth RJ, Rowlingson JC. Cervicogenic headache in patients with presumed migraine: missed diagnosis or misdiagnosis? J Pain. 2005;6:700–3.

    Article  Google Scholar 

  4. Antonaci F, Sjaastad O. Cervicogenic headache: a real headache. Curr Neurol Neurosci Rep. 2011;11:149–55.

    Article  Google Scholar 

  5. Headache Classification Committee. The international classification of headache disorders, 2nd ed. Cephalalgia. 2004;24:8–152.

    Google Scholar 

  6. Arnold G. Die örtliche Injecktiosbehandlung okzipitaler und subokzipitaler Schmerzzustände. Munch Med Wochenschr. 1969;111:138–41.

    CAS  PubMed  Google Scholar 

  7. Mosser SW, Guyuron B, Janis JE, Rohric RJ. The anatomy of the greater occipital nerve: implications for the etiology of migraine headaches. Plast Reconstr Surg. 2004;113:693–7.

    Article  Google Scholar 

  8. Kuhn WT, Kuhn SC, Gilberstadt H. Occipital neuralgias: clinical recognition of a complicated headache. A case series and literature review. J Orofac Pain. 1997;11:158–65.

    CAS  PubMed  Google Scholar 

  9. Dash KS, Janis JE, Guyuron B. The lesser and the third occipital nerves and migraine headache. Plast Reconstr Surg. 2005;115:1752–8.

    Article  CAS  Google Scholar 

  10. Ducic I, Hartmann EC, Larson EE. Indications and outcomes for surgical treatments of patients with chronic migraine headaches caused by occipital neuralgia. Plast Reconstr Surg. 2009;123:1453–61.

    Article  CAS  Google Scholar 

  11. Hunter CR, Mayfield FH. Role of the upper cervical roots in the production of pain in the head. Am J Surg. 1949;48:743–51.

    Article  Google Scholar 

  12. Klinger M, Villani F, Klinger F, Gaetani P, Rodriguez y Baena R, Levi D. Anatomical variations of the occipital nerves: implications for the treatment of chronic headaches. Plast Reconstr Surg. 2009;124:1727–8.

    Article  CAS  Google Scholar 

  13. Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg. 2006;118(Suppl 3):108S–20S.

    Article  CAS  Google Scholar 

  14. Klinger M, Lisa A, Klinger F, Giannasi S, Veronesi A, Banzatti B, Bandi V, Catania B, Forcellini D, Maione L, Vinci V, Caviggioli F. Regenerative approach to scars, ulcers and related problems with fat grafting. Clin Plast Surg. 2015;42(3):345–52.

    Article  Google Scholar 

  15. Maione L, Vinci V, Caviggioli F, Klinger F, Banzatti B, Catania B, Lisa A, Klinger M. Autologous fat graft in postmastectomy pain syndrome following breast conservative surgery and radiotherapy. Aesthet Plast Surg. 2014;38(3):528–32. https://doi.org/10.1007/s00266-014-0311-9.

    Article  Google Scholar 

  16. Rigotti G, Marchi A, Galiè M, et al. Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adiposederived adult stem cells. Plast Reconstr Surg. 2007;119:1409–22.

    Article  CAS  Google Scholar 

  17. Zuk PA, Zhu M, Ashjian P, et al. Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell. 2002;13:4279–95.

    Article  CAS  Google Scholar 

  18. Mazo M, Planat-Bénard V, Abizanda G, et al. Transplantation of adipose derived stromal cells is associated with functional improvement in a rat model of chronic myocardial infarction. Eur J Heart Fail. 2008;10:454–62.

    Article  Google Scholar 

  19. Zhang DZ, Gai LY, Liu HW, Jin QH, Huang JH, Zhu XY. Transplantation of autologous adiposederived stem cells ameliorates cardiac function in rabbits with myocardial infarction. Chin Med J. 2007;120:300–7.

    Article  Google Scholar 

  20. Villani F, Caviggioli F, Klinger F, Klinger M. Rehabilitation of irradiated head and neck tissues by autologous fat transplantation. Plast Reconstr Surg. 2009;124:2190–1.

    Article  CAS  Google Scholar 

  21. Klinger M, Caviggioli F, Vinci V, Salval A, Villani F. Treatment of chronic posttraumatic ulcers using autologous fat graft. Plast Reconstr Surg. 2010;126:154e–5e.

    Article  Google Scholar 

  22. Villani F, Caviggioli F, Klinger F, Maione L, Klinger M. Fat graft before breast reconstruction by latissimus dorsi. Plast Reconstr Surg. 2010;126:190e–1e.

    Article  Google Scholar 

  23. Güvençer M, Akyer P, Sayhan S, Tetik S. The importance of the greater occipital nerve in the occipital and the suboccipital region for nerve blockade and surgical approaches—an anatomic study on cadavers. Clin Neurol Neurosurg. 2011;113:289–94.

    Article  Google Scholar 

  24. Bovim G, Fredriksen TA, Stolt-Nilsen A, Sjaastad O. Neurolysis of the greater occipital nerve in cervicogenic headache. A follow-up study. Headache. 1992;32:175–9.

    Article  CAS  Google Scholar 

  25. Gille O, Lavignolle B, Vital JM. Surgical treatment of greater occipital neuralgia by neurolysis of the great occipital nerve and sectioning of the inferior oblique muscle. Spine. 2004;29:828–32.

    Article  Google Scholar 

  26. Guyuron B, Kriegler JS, Davis J, Amini SB. Comprehensive surgical treatment of migraine headaches. Plast Reconstr Surg. 2005;115:1–9.

    CAS  PubMed  Google Scholar 

  27. Pikus J, Philips JM. Characteristics of patients successfully treated for cervicogenic headache by surgical decompression of the second cervical root. Headache. 1995;35:921–9.

    Article  Google Scholar 

  28. Vanelderen P, Rouwette T, De Vooght P, et al. Pulsed radiofrequency for the treatment of occipital neuralgia: a prospective study with 6 months of follow-up. Reg Anesth Pain Med. 2010;35:148–51.

    Article  Google Scholar 

  29. Schwedt TJ. Occipital nerve stimulation for medically intractable headache. Cur Pain Headache Rep. 2008;12:62–6.

    Article  Google Scholar 

  30. Slavin KV, Nerseyan H, Wess C. Peripheral neurostimulationfor treatment of intractable occipital neuralgia. Neurosurgery. 2006;58:112–9.

    Article  Google Scholar 

  31. Taylor M, Silva S, Cottrell C. Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: a pilot study. Headache. 2008;48:1476–81.

    Article  Google Scholar 

  32. Daar AS, Greenwood HL. A proposed definition of regenerative medicine. J Tissue Eng Regen Med. 2007;1:179–84.

    Article  CAS  Google Scholar 

  33. Gaetani P, Klinger M, Levi D, Bussone G, Giannasi S, Caviggioli F, Marazzi M, Broggi G. Treatment of chronic headache of cervical origin with lipostructure: an observational study. Headache. 2013;2013(53):507–13.

    Article  Google Scholar 

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Authors and Affiliations

  1. Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Rozzano, MI, Italy

    Marco Klinger, Luca Maione & Silvia Giannasi

  2. Plastic Surgery Unit, MultiMedica Holding S.p.A, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Milan, Italy

    Francesco Klinger

Authors
  1. Marco Klinger
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  2. Luca Maione
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  3. Francesco Klinger
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  4. Silvia Giannasi
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Corresponding author

Correspondence to Marco Klinger .

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Editors and Affiliations

  1. Department of Medicine and Surgery, University of Parma, Parma, Italy

    Edoardo Raposio

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Klinger, M., Maione, L., Klinger, F., Giannasi, S. (2020). The Use of Fat Grafting for Chronic Headache of Cervical Origin Treatment. In: Raposio, E. (eds) Atlas of Surgical Therapy for Migraine and Tension-Type Headache. Springer, Cham. https://doi.org/10.1007/978-3-030-29505-9_16

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  • DOI: https://doi.org/10.1007/978-3-030-29505-9_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-29504-2

  • Online ISBN: 978-3-030-29505-9

  • eBook Packages: MedicineMedicine (R0)

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