Abstract
A 29-year-old man with medically refractory right-sided chronic cluster headache presented with increased attack frequency. As a bridging therapy, we considered a greater occipital nerve (GON) injection with corticosteroids and local anesthetic. Delving through his childhood medical records, it came to light he had an incidental right cerebellopontine angle dermoid excised. He could not recall the details of this; therefore, plain skull X-ray (figure 1) and head CT (figure 2) were performed. Neuroimaging is required before proceeding with GON injection if there is any suggestion of past neurosurgical intervention. There is a risk of causing loss of consciousness with GON injections into nonintact skull.1,2
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