High‐volume anaesthetic suboccipital nerve blocks (HVSON) showed promising results in managing the medicinal refractory chronic cluster headache (CCH) along with compatible response at long-term use, reported as the Open-Label, Observational Case Series Study led by Dr Todd Rozen.

Suboccipital nerve blocks is a therapeutic method which alleviates pain arising from the back of the head. This method involves injecting of anaesthetic into the skull base, where the suboccipital nerves are present. Various studies have shown the efficacy of occipital and suboccipital nerve blocks in CCH management, but the long-term efficacy data had not been available. Patients with the 7-year disease period and injected on at least 2 different times at a headache clinic were selected. The HVSON involved 1 mL triamcinolone 40 mg/mL and 9 mL 1% lidocaine which is delivered at the side of CH pain.

A total of ten patients were involved in the analysis whose HVSON range of mean average response was 1.5–31 weeks. Seven patients showed 4 weeks of response; two showed 1.5-2 weeks of response and remained one patient did not show any response. Responders exhibited about 10.3 weeks mean average duration of effect. Five patients received injections for 2–4 years serially with a constant response of 6 weeks, 4 weeks, 12 weeks, 4 weeks, and 31 weeks, respectively, following every injection. Response duration was very strong per patient. All the 5 patients presented HVSON as a preventive therapy. Treatment response did not alter by smoking history as eight out of 10 were current smokers and out of them, seven treated with HVSON. One patient due to getting most injections exhibited avascular necrosis of the hip, but rest displayed no adverse events. These findings explain that the HVSON has a significant role in managing CCH.