Primary Cough Headache Responded to Ultrasound Guided Greater Occipital Nerve Block: A Case Report.

Introduction: Primary Cough Headache (PCH) is a rare type of headache and needs to be evaluated after exlusion of secondary reasons. There are limited number of case reports in the literature about treatment modalities.

Case: Herein, we report that a 42-year-old female patient with PCH who could not use the oral medication because of side effects. When she came to the pain clinic with an attack with intensity of 9/10 , we took her to the local operating room. The ultrasound (US) guided proximal greater occipital nerve block with bupivacaine was performed and the intensity of the attack was reduced to 2/10. The blockage was repeated once a week for a month. After two months, both the intensity of headache and number of attacks decreased and no adverse effect was observed.

Conclusion: PCH is a challenge for physicians because of the severity of attacks and difficulty in ruling out secondary causes at the time of diagnosis. The US-guided PGONB can be performed in the emergency department for the PCH when medical treatment fails.