Epidural blood patch is a current standard treatment for patients with post-dural puncture headache (PDPH) or spontaneous intracranial hypotension headache (SIHH), but it is an invasive procedure with a potential for serious complications. Recent studies have found evidences for the efficacy of greater occipital nerve block (GONB) in the management of them. We present three cases of postural headache that were relieved after bilateral GONB. The temporary reduction in afferent signals to the trigeminal nucleus caudalis may lead to an inhibition of the central sensitization that causes the headache. Treatment of PDPH or SIHH with “bilateral GONB,” which is a minimally invasive and easy method with a low complication rate may be considered before the application of a blood patch or a successful alternative treatment for patients.

Keywordsgreater occipital nerve block, post-dural puncture headache, spontaneous intracranial hypotension headache, trigeminal nucleus caudalis, ultrasound.