Neurosurgeon pinpoints and treats woman’s debilitating headache
Occipital neuralgia can be a challenging diagnosis
Most of us have had a bad headache at one time or another. And then, there’s Kathie Rohloff, 51, of Royal Oak. About one year ago, she experienced what she calls, “The headache of my life.” It lasted eight months. How bad was it? So bad, that the radiology technologist had to take a three-month leave of absence from her job.
| Kathie and Mark Rohloff celebrating their daughter's
August wedding on Mackinac Island.
Kathie remembers taking her granddaughter to the playground. At the time it seemed innocent enough. She pulled herself up on some equipment that glides across a track, like a zip line. Almost immediately, she felt a pull in her neck and some pain. Within minutes the pain escalated and became agonizing. “It was horrific,” she explains.
Her husband rushed her to Beaumont’s emergency center. She thought her intense headache could be the result of an aneurysm or stroke, but imaging tests showed otherwise. They kept her overnight for further observation. Her pain seemed to decrease, but it didn’t disappear. She was released with pain medication.
Kathie returned to work, but the headache affected her neck and side-to-side motion of her head. “The pain felt like an ice pick,” she recalls.
With her ongoing pain, she sought help. One doctor used steroid injections. They didn’t work. Radiofrequency ablation was used on the nerve in her neck, but that did not provide relief.
Pain was taking over her life. It not only affected her ability to perform her job, but family life too. Her husband did all the household duties. She was prescribed an anti-depressant and after five months she took a leave from her workplace. Her co-workers, friends and family saw how the pain had changed her. She lived in silence. She no longer smiled. Kathie recalls, “My life was totally different then. It wasn’t even a life.”
Despite the pain, she persevered, looking for a treatment of her endless headache. Kathie even went through physical therapy sessions - still no relief. For a while she visited a chiropractor. The pain continued. Finally, a pain block administered to the occipital nerve provided a valuable clue. The block worked, providing temporary relief. The occipital nerves are responsible for feeling in the top and back of the head. One nerve provides sensation to the left side of the head, the other to the right.
Then, Kathie was referred to Beaumont neurosurgeon Holly Gilmer, M.D. On her first visit, Dr. Gilmer ordered an MRI. The images showed an impingement in Kathie’s occipital nerve. Dr. Gilmer explained the nerve was scarred to the muscle. Eight months after her trip to the playground, the source of her debilitating pain was finally identified. The condition is known as occipital neuralgia. Dr. Gilmer decided the best way to treat her pain was through surgery.
Explains Dr. Gilmer, “This condition is characterized by intense pain on just one-side of the head. It’s like carpal tunnel in the scalp.”
There are many causes of occipital neuralgia and in Kathie’s case Dr. Gilmer believes it might have been a whiplash injury.
During the procedure, Dr. Gilmer identified the occipital nerve causing her pain and all the branches just above the scalp. The nerve and all its branches were then cut and cauterized.
“When I woke up the pain was totally gone,” says Kathie following surgery.
After two weeks, she returned to work. “I’m grateful for the skill and expertise of Dr. Gilmer.”
It’s been six months since the procedure and she is still pain-free.
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