A throbbing pain in the back of the head may be occipital neuralgia.1 Occipital neuralgia includes primary and secondary causes. The exact cause of primary is not clear, mainly symptomatic treatment, can be oral carbamazepine and oxcarbazepine, can also be oral phenytoin sodium. The patient’s headache is generally more intense, can appear suddenly, the patient’s headache is mostly episodic, short duration, can last for a few seconds to 1-2 minutes, can be suddenly stopped.2, the patient’s headache can be several times a day or dozens of episodes, may also be due to intracranial organisms caused by the lesion. Generally, it is mainly seen in the lesion of posterior cranial fossa, commonly seen in cerebellar and brainstem tumors, and should be examined by cranial brain MRI in order to make a clear diagnosis.3. If the patient is cervical spondylosis, it may also cause the above symptoms, which is mainly due to the contraction of neck and shoulder muscle spasm, and the pulling of scalp nerves can also be seen in the patients with high blood pressure.