• Adrian Kastler, Arnaud Attyé, Caroline Maindet, Benjamin Nicot, Emmanuel Gay, Bruno Kastler, and Alexandre Krainik.
• Neuroradiology and MRI Unit, University Hospital of Grenoble-Alpes, 38000 Grenoble, France. Electronic address: kastler.radio@gmail.com.
• J Neuroradiology. 2018 Oct 1; 45 (6): 386-390.

ObjectiveTo assess technical feasibility of cryoneurolysis of the greater occipital nerve in the management of occipital neuralgia.MethodsSix patients suffering from unilateral refractory greater occipital neuralgia and who underwent 7 GON cryoneurolysis were assessed between October 2015 and January 2017. All procedures were performed under CT guidance and local anesthesia. A planning CT was performed with contrast enhancement to plan needle target and identify surrounding major vascular structures. A 12G coaxial needle (Inomed) was then inserted and targeted the first bend of the GON under and lateral to the obliquus capitis inferior muscle. A 2.0mm cryoprobe was then inserted in the coaxial and sensitive stimulation at 100Hz was performed. One to three freezing cycles were performed in one session.ResultsTechnical feasibility was 100% as cryoneurolysis could be performed in all 7 cases with accurate sensitive nerve stimulation prior to freezing cycle. One patient benefited from a second session after failure of the first session. More than 50% pain reduction was achieved at day 7 in all cases, and 5 of 6 cases at one and three months follow-up.ConclusionCryoneurolysis of the GON in the management of refractory GON neuralgia is feasible. Initial results are promising as 5/7 cases benefited from a 3-month pain alleviation period.Copyright © 2018 Elsevier Masson SAS. All rights reserved.

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