Subarachnoid Hemorrhage Following Cervical Medial Branch Radiofrequency Ablation: A Case Report.

BACKGROUND: Facet-mediated neck pain following motor vehicle collision is a common component of whiplash-associated disorder. Facet-mediated neck pain is suspected based on a combination of history, physical examination, and imaging findings. Third occipital nerve (TON) and cervical medial branch radiofrequency ablation (RFA) are effective and safe approaches to facet-mediated pain. Serious complications are rare but can include nerve root, spinal cord, and vascular injury. CASE REPORT: This report describes a case of subarachnoid hemorrhage (SAH) that occurred within 24 hours following TON and cervical medial branch RFA. The patient was admitted for symptom management, blood pressure control, and follow-up imaging. His hemorrhage stabilized, and he returned home without residual deficits after 12 days. CONCLUSIONS: This case serves as an example of how prolonged nausea, headache, and ataxia can be indicators of SAH, following TON and cervical medial branch RFA.