Abstract: Objective To investigate the incidence, possible mechanisms, clinical features of severe headache after posterior fossa craniotomy. Methods 119 neurosurgical patients undergoing selective posterior fossa craniotomy were analyzed retrospectively. Results 45 （37.8%） patients experienced severe postoperative pain, which could be identified as neuralgia (19 cases), cervicogenic headache (9 cases) and incision of scalp pain （17 cases）. Conclusion In addition to neuralgia and incision of scalp pain, cervicogenic factor plays an important role in severe headache after posterior fossa craniotomy.

Key words: craniotomy, headache, cervicogenic headache, neuralgia