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.
Keywords: cough headache, GONB, PCH, proximal greater occipital
nerve block, ultrasound