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Abstract Details

Safety and Efficacy of Sphenopalatine Ganglion Block in Post-Stroke Headache Cohort: A Single Center Experience
Cerebrovascular Disease and Interventional Neurology
P6 - Poster Session 6 (5:30 PM-6:30 PM)
13-005

Recent literature suggests that post-stroke headache occurs in 4%-6% of ischemic stroke patients with tension-type features being the leading cause. Due to their side effect profile, drugs such as triptans and ergotamines have contraindications in this population. Additionally, there is not enough clinical data to safely support the use of gepants in the acute stroke population. Lasmiditan has limited use due to 8 hours driving restriction. Thus, abortive headache treatments are often limited to opioids and butalbital combinations. SPG block is a non-invasive procedure where an anesthetic agent is injected into the nares, reaching the SPG in order to relieve pain and autonomic features. Robust literature has shown SPG block is effective in acute migraine; however, the use of SPG block in post-stroke headache has not been reported.

To examine the safety and efficacy of Sphenopalatine Ganglion (SPG) block in post-stroke headache.

We performed a retrospective analysis at the University of Utah Health and queried charts of patients with a diagnosis of post-stroke headache confirmed by a neurologist who received at least one SPG block procedure between January 2000 to October 2021.

We identified over 550 unique patients with a possible post-stroke headache diagnosis who received at least one SPG block. Average age is 56.9±15.9 (range from 19 to 96), with 55% female (n=301). At baseline, we will identify patient’s headache subtype, frequency, previous treatment, demographic data, and clinical data. We will compare patient’s pre and post-procedure’s pain level and document relief of most bothersome symptom prior to treatment and at 30 minutes, 1 hour, and 2 hours post-treatment.

SPG block may be an efficacious treatment for post-stroke headache. As local anesthetic agents have a low side-effect profile and minimal risk of dependence; SPG block may be an important alternative to current treatment options including opioids, butalbitals, and lasmiditan. 

Authors/Disclosures
Cecilia Peterson
PRESENTER
An immediate family member of Ms. Peterson has received personal compensation for serving as an employee of 100Plus.
Ka-Ho Wong (U of U Neurology Clinic) The institution of Mr. Wong has received research support from The Sumaira Foundation .
Marissa M. Castillo (U of U Neurology Clinic) Ms. Castillo has nothing to disclose.
Varsha Muddasani, MBBS (Einstein Medical Center) Dr. Muddasani has nothing to disclose.
Nazanin Sheibani, MD (Tremont) Dr. Sheibani has nothing to disclose.
No disclosure on file
Kayla Navarro Miss Navarro has nothing to disclose.
Gauri Garg Ms. Garg has nothing to disclose.
Seniha N. Ozudogru, MD (University of Pennsylvania) Dr. Ozudogru has nothing to disclose.
Adam De Havenon, MD, FAAN (Yale University) Dr. De Havenon has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novo Nordisk. Dr. De Havenon has stock in Certus. Dr. De Havenon has stock in TitinKM. The institution of Dr. De Havenon has received research support from NIH/NINDS. Dr. De Havenon has received publishing royalties from a publication relating to health care.