Chronic headache relief after section of suboccipital muscle dural connections: a case report

The presence of a connective tissue bridge, attaching suboccipital muscles to the dura mater, is now recognized as a feature of normal human anatomy. The role that this myodural bridge may play in headache production is uncertain; however, a new conceptual model is emerging. Postsurgical myodural adhesions have been reported as a complication resulting from excision of acoustic tumors. Extensive research now exists implicating these myodural adhesions as a possible source of postoperative headache. Integrating these 2 types of myodural unions (anatomic and pathologic) into a unified theory of headache production, we report a single patient who experienced relief from chronic headache after surgical separation of the myodural bridge from the suboccipital musculature.