{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T01:20:31Z","timestamp":1773451231369,"version":"3.50.1"},"reference-count":41,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Lead migration is a complication associated with occipital nerve stimulation (ONS). We present a rare case in which fibrosis in the stress relief loop caused lead migration in the treatment of occipital neuralgia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 30-year-old woman with a 5-year history of refractory occipital neuralgia, who had been under ONS therapy for 2 months, presented with a sudden onset of typical occipital neuralgia pain associated with cervical muscles spasms and myoclonus. A skull radiography showed lead migration. The patient underwent surgery for lead repositioning. During surgery, we identified extensive fibrosis throughout the stress relief loop that produced several constriction points. The fibrosis in the stress relief loop increased tension on the lead during head-and-neck movement, causing progressive migration of the lead.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Although lead migration is a common complication of ONS, its association with fibrosis in the stress relief loop has not, to the best of our knowledge, been reported before. Lead migration can directly affect treatment outcome and it is, therefore, important to fully understand the possible mechanisms that can cause it and how to promptly manage them.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_158_2021","type":"journal-article","created":{"date-parts":[[2021,4,25]],"date-time":"2021-04-25T18:37:43Z","timestamp":1619375863000},"page":"189","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["An unusual case of lead migration in occipital nerve stimulation: A case report and literature review"],"prefix":"10.25259","volume":"12","author":[{"given":"Rafael","family":"Caiado Vencio","sequence":"first","affiliation":[{"name":"Department of Medicine, Graduation Medicine, Pontifical Catholic University of Goi\u00e1s, Goi\u00e2nia, Goi\u00e1s, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo Eduardo Albuquerque Zito","family":"Raffa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Graduation Medicine, Catanduva Medical School (FAMECA-UNIFIPA), Catanduva, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9 Costa Corral","family":"Ponce","sequence":"additional","affiliation":[{"name":"Department of Medicine, Graduation Medicine, Faculty of Medicine of ABC, Santo Andr\u00e9, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno Pricoli","family":"Malamud","sequence":"additional","affiliation":[{"name":"Department of Medicine, Graduation Medicine, Faculty of Medicine of ABC, Santo Andr\u00e9, S\u00e3o Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9sar Cozar","family":"Pacheco","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Santa Paula Hospital, S\u00e3o Paulo, 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