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Stopping Head Pain: SPG Block for Concussion and Migraines

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A popular treatment used to stop migraine pain is also being put to use to stop the pain causedfrom concussions and other traumatic brain injuries. The treatment is known as the SphenoCath procedure and delivers a powerful anesthetic behind the nasal cavity to block pain for up to four months.


Concussions have been in the spotlight for the last few years. This is in part because of the NFL lawsuit and concerns about chronic traumatic encephalopathy, popularly known as CTE, and because of advances in medicine that show the after effects of concussions to be more serious than once thought.

Millions of concussions occur in the United States each year. According to the Brain Injury Research Institute, there are between 1.9 and 3.8 million concussions annually from sports and recreational activities alone. Other causes include falls, car accidents and any other trauma that causes the brain to collide with the bones of the skull.

The brain is surrounded by cerebral spinal fluid inside the skull that cushions the brain and keeps it from sliding into the hard bones of the skull during natural, everyday movements like walking and running.  A concussion occurs when an individual experiences a violent trauma or injury that pushes the brain through this fluid and causes the brain against the skull.

Concussions disrupt the normal operations of the brain, and often lead to symptoms like confusion, extreme fatigue and feeling dazed. Other after effects include depression, slurred speech and irritability. Most of the time these symptoms go away after a few weeks, but some patients can experience symptoms for years after their injury.

Many patients experience intense and long-lasting head pain because of their concussion.

This pain is disruptive to activities, relationships, work and diminishes the overall quality of life for concussion patients.

This is where the SphenoCath has been found to help. The SphenoCath is a small, catheter like device that is placed into a concussion patient’s nose to deliver anesthesia to block the patient from feeling head pain.

Dr. Michael Budler is an interventional radiologist in Grand Island, Nebraska, who uses the SphenoCath device to treat migraine patients.

"The SphenoCath SPG block is an excellent option for patients who experience chronic head pain," Budler said.

Like concussion pain, migraine pain can be debilitating and very disruptive to leading a normal life for many individuals. Many migraine sufferers experience depression as a result of their condition.

Around 12 percent of Americans suffer from migraines, and migraines are ranked at the sixth most disabling illness in the world. Four million migraine sufferers report daily head pain.

Migraines are triggered when a stimulus aggravates the SPG and induces the body to produce a pain response. Migraine triggers vary between individuals but commonly include stress, changes in weather, caffeine consumption, food preservatives and exposure to bright lights or certain fragrances.

Budler performs the SphenoCath SPG block outpatient procedure in his office.

"The whole procedure takes only about 15 minutes," Budler said.

During the procedure, a fine anesthetic mist is applied to the inside of the nose. Guided by real-time X-ray, Budler inserts the catheter into the nasal cavity. The catheter drips the anesthetic medication onto the SPG and is absorbed by the body.

"The medication used during the SPG block gives an immediate reset to the SPG and gives patients immediate relief," Budler said.

The SphenoCath SPG block does require ongoing treatment. Most patients require three treatments per year.

The procedure is also beneficial for patients with trigeminal neuralgia facial pain and maxillary upper jaw pain caused by root canals, and other types of chronic head pain. 



NBC DFW. "Catheter Procedure Helps Stop Concussion Headaches." 3 April 2017

Brain Injury Research Institute. "What is a Concussion?" 2017

Migraine Research Foundation. "Migraine Facts". 2017.

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