Characteristic of supraorbital neuralgia after subfrontal craniotomy and intraoperative nerveprotection

Objective To explore the clinical features and incidence of supraorbital neuralgia after subfrontal craniotomy,then study its therapeutic and intraoperative protection strategies.Methods Control group included 132 neurosurgical patients undergoing selective subfrontal craniotomy and the experimental group was consisted of patients operated with modified subcutaneous stratum dissection skill.The onset,severity,and character of the neuralgia were recorded. The therapeutic effects of medicine and neural blockade on neuralgia were observed. Results In control group, 13 (9.8％ )patients suffered from postoperative supraorbital neuralgia,it began 3 -4 days after subfrontal craniotomy.The headache could be persistent and became more serious intermittently and irradiated to frontal,parietal,temperal,and para -orbital region. Physical examination revealed homolateral tenderness of supraorbital notch. Severity of headache improved dramatically after neural blockade therapy.There was no supraorbital neuralgia occurred in the experimental group.Conclusions It is important to identify supraorbital neuralgia after subfrontal craniotomy.Neural blockade therapy gets excellent clinical result in treating post -craniotomy neuralgia,modified subcutaneous stratum dissection skill can reduce the occurrence of supraorbital neuralgia. Key words: Neuralgia ;  Neural blockade ;  Neurosurgical procedures