Perineural botulinum toxin in the management of post-traumatic headache: A case report.

Post traumatic headache is a common condition that can be managed with pharmacologic interventions or analgesic procedures; however, most evidence is derived from patients with mild trauma, leaving a large gap with regard to patients with moderate or severe trauma who present complex pain. Botulinum toxin plays an increasingly important role in pain management. This neurotoxin acts on different receptors, ranging from TRPV1 (transient receptor potential vanilloid type 1) to CGRP (calcitonin gene-related peptide). This is the first case report of the use of perineural botulinum toxin in a patient with moderate post-traumatic headache who responded poorly to standard interventional measures.