Image-guided treatment shown to break the migraine
cycle: 88 percent of patients report using less
pain-relief medicine after interventional radiology
The innovative interventional radiology treatment
has been found to offer chronic migraine sufferers
sustained relief of their headaches, according to
research being presented at the Society of
Interventional Radiology’s Annual Scientific
Clinicians at Albany Medical Center and the State
University New York Empire State College in Saratoga
Springs used a treatment called image-guided,
intranasal sphenopalatine ganglion (SPG) blocks to
give patients enough ongoing relief that they
required less medication to relieve migraine pain.
“Migraine headaches are one of the most common,
debilitating diseases in the Unites States, and the
cost and side effects of medicine to address
migraines can be overwhelming,” said Kenneth
Mandato, M.D., the study’s lead researcher and an
interventional radiologist at Albany Medical Center.
“Intranasal sphenopalatine ganglion blocks are
image-guide, targeted, breakthrough treatments.
They offer a patient-centered therapy that has the
potential to break the migraine cycle and quickly
improve patients’ quality of life,” he added.
Mandato and his team conducted a retrospective
analysis of 112 patients suffering migraine or
cluster headaches. Patients reported the severity of
their headaches on a visual analogue scale (VAS),
ranging from 1–10, to quantify the degree of
debilitation experienced from the migraine.
During the treatment, which is minimally invasive
and does not involve needles touching the patient,
researchers inserted a spaghetti-sized catheter
through the nasal passages and administered 4
percent lidocaine to the sphenopalatine ganglion, a
nerve bundle just behind the nose associated with
Before treatment, patients reported an average VAS
score of 8.25, with scores greater than 4 at least
15 days per month.
The day after the SPG block patients’ VAS scores
were cut in half, to an average of 4.10.
Thirty days after the procedure, patients reported
an average score of 5.25, a 36 percent decrease from
pretreatment. Additionally, 88 percent of patients
indicated that they required less or no migraine
medication for ongoing relief.
“Administration of lidocaine to the sphenopalatine
ganglion acts as a ‘reset button’ for the brain’s
migraine circuitry,” noted Mandato. “When the
initial numbing of the lidocaine wears off, the
migraine trigger seems to no longer have the maximum
effect that it once did.
Some patients have reported immediate relief and are
making fewer trips to the hospital for emergency
headache medicine,” he said.
Because of the minimally invasive nature of the
treatment and the medication’s safety profile,
Mandato believes patients can have the SPG block
repeated, if needed.
While patients reported relief from their migraines,
Mandato added that SPG blocks are not a cure for
migraines; they are a temporary solution as are
other current treatment options for chronic
To further study SPG blocks, Mandato will track how
the 112 patients have responded six months after
treatment. He is also considering conducting a
double-blind, prospective study to more rigorously
evaluate the effectiveness of SPG blocks in treating
For more information
Abstract 77: “Image-guided sphenopalatine ganglion
blocks: An IR solution for chronic headaches,” K.
Mandato, G. Siskin, R. Tartaglione, G. Bolotin, C.
Stavrakis, M. Englander, L. Keating, A. Herr,
Radiology, Albany Medical Center, N.Y.; D. Geer,
SUNY Empire State College, Saratoga Springs, N.Y.;
SIR Annual Scientific Meeting, Feb. 28–March 5.