Greater occipital nerve

Synonyms
Großer Hinterhauptnerv

The greater occipital nerve is a peripheral nerve that arises from the second of the Spinal nerves. It traverses the trapezius muscle and courses toward the occipital region.

Innervation

In the neck region, the greater occipital nerve provides motor innervation to the semispinalis muscle, the Musculus longissimusMusculus splenius

Clinical relevance

  • During surgical stabilization of the Atlas, the greater occipital nerve may be injured during preparation of the posterior arch of the atlas or placement of the screws.

  • The greater occipital nerve may be injured during paramedian suboccipital approaches, such as a supracerebellar infratentorial approach.

Figure

Nervus occipitalis major
Schematic illustration of the nervus occipitalis major. Image adapted from Gray’s Anatomy.
Intraoperative visualization of the greater occipital nerve
Intraoperative visualization of the greater occipital nerve during a paramedian supracerebellar infratentorial approach. Figure adapted from Rhomberg, Thomas, and Henry WS Schroeder. Microsurgical Resection of a Pineal Cyst via a Paramedian Supracerebellar Infratentorial Approach. World Neurosurgery 185 (2024): 113.

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