Ultrasound guided greater occipital nerve blocks for post-traumatic occipital neuralgia

Chronic headaches can be debilitating for many patients. They often have a nebulous etiology, unpredictable course, and can be difficult to manage. We describe a post-traumatic headache that began after a motor vehicle collision. The patient sustained multiple injuries including a scalp laceration and bilateral occipital condyle fractures. Oral agents were unable to quell this patient's headaches. The diagnosis of occipital neuralgia was suspected based on history and presentation. Our patient received dramatic relief after ultrasound guided bilateral greater occipital nerve blocks.