Open Access

Great occipital nerve blockade for cluster headache in the emergency department: case report

  • L. Scattoni1Email author,
  • F. Di Stani1,
  • V. Villani1,
  • D. Dugoni1,
  • C. Mostardini1,
  • C. Reale1 and
  • R. Cerbo1
The Journal of Headache and Pain20067:283

Received: 5 January 2006

Accepted: 29 March 2006

Published: 26 April 2006


A 44-year-old man with a past medical history of episodic cluster headache presented in our ED with complaints of multiple daily cluster headache attacks, with cervico-occipital spreading of pain from May to September 2004. The neurological examination showed no abnormalities as well as brain and spine MRI. Great Occipital Nerve (GON) blockade, with Lidocaine 2% (5 ml) and betamethasone (2 mg), were performed in the right occipital region (ipsilaterally to cluster headache), during attack. GON blockade was effective immediately for the attack and the cluster period resolved after the injection. We suppose that the action of GON blockade may involve the trigemino-cervical complex and we moreover strongly suggest to use GON blockade in emergency departments for cluster headache with cervico-occipital spreading as attack abortive therapy, especially in oxygen and sumatriptan resistant cluster headache attacks, in patients who complaints sumatriptan side-effects or have contraindications to use triptans.

Key words

Great occipital nerve blockadeCluster headacheEmergency department