Occipitial Neuralgia and Cranial Instability

Hello everyone, I had decompression surgery roughly two years ago and I believe the surgery was successful. I do not experience Chiari headaches as I did before, and movements like bending over, coughing, and sneezing no longer trigger headaches. However, I am still having headaches and it's becoming harder to ignore. For example, craning my neck for more than a few seconds is rather painful, and as a college student I spend a lot of time looking down with my neck bent forward as I work on homework or study. When this happens, the pain tends to begin in my neck and then sort of spread upwards in my temples and behind my eyes. I've connected with many Chiari patients on Tumblr and Instagram, and learned of occipital neuralgia and cranial-cervical instability, and I'm worried I may have it. The occipital nerve runs from the top of the spinal cord and into the neck - AKA, where my Chiari is located and I think the compression may have damaged the nerves there.

Cranial instability and occipital neuralgia are both somewhat related to Chiari, and I was just wondering if anyone on this site has been diagnosed with either occipital neuralgia or cranial instability. I'm not even sure what kind of doctor I would see for this, my neurosurgeon most likely? I wonder though if I'm being a hypochondriac because I feel like my doctor would have already seen this problem, but maybe not. I'm just really confused and not sure what to do.

Lindsay, I had cranio cervical instability and was fused last August. You do need to see a NS, but any Chiari NS will do, they won't know how to recognize it. ANY ns will know how to look for cci caused by trauma, but ours is different and requires a an NS who who specifically studies cci for non-trauma. Lots of chiarians have eds or some type of hypermobility syndrome- this is usually where our cci stems. Depending on a joe shmo NS and radiologist for a diagnosis is pointless, they will tell you that you don't have it just because they are unable to recognize it in imaging. These are the NSs, who I am aware of, who know how to screen for cci:

Fraser Henderson, md
Patel, sc (duke)
Frim, il
Sandhu, md
Rosner, nc
Trimble, fl


I'm glad you are looking into it Lindsay. Wearing a cervical collar can alleviate symptoms of cci, especially at night while you sleep. Fix your surroundings so you don't bend your neck down to study and read.

I don't have occip neuralgia so can't help you with that... I hear it feels like "fire lines" up the back of your head.

Good luck!!! Jenn

Hi Jen, thanks so much for the quick reply - would you say the fusion was successful?

Yes it was, pain went from 7-8 down to an ave of 2. I wish I had done it sooner. :slight_smile: