A Patient with Upper Cervical Spinal Cord Infarction Presenting with the Sudden Onset of Severe Occipital Headache Followed by Occipital Neuralgia

A 78-year-old man suddenly developed a severe occipital headache, followed by right greater occipital neuralgia (ON). Brain MR imaging revealed a spinal cord infarction in the territory of the right posterior spinal artery (PSA) at the C2 level without vertebral artery (VA) dissection. Even without VA dissection, upper cervical PSA syndrome could cause severe occipital headache. Furthermore, ipsilateral ON could follow it. The present case suggests that severe occipital headache and ON can occur in a patient with upper cervical PSA syndrome without VA dissection.