Nerve Blocks for Post-Traumatic Headache
Trial Summary
What is the purpose of this trial?
Post-traumatic headaches (PTH) are the most common complaint after traumatic brain injury, possibly generated by a number of stressors to the trigeminovascular and cervical plexus networks, including inflammation of the high cervical facet joints, traumatic cranial neuralgias, migraines, and myofascial injuries. To date, no treatment guidelines exist for PTH management except for conservative modalities, such as cognitive rest, physical therapy, and neuropathic pain medications, all of which have minimal evidence to support them.The investigators propose a randomized, controlled, clinical trial and prospective follow-up study to evaluate the effect of invasive procedures such as occipital nerve block (ONB) and cervical medial branch block (CMBB) in the management of PTH.Adolescents and adults (14-45 years of age) will be recruited from Boston Children's Hospital and Beth Israel Deaconess Medical Center Pain clinics, Concussion clinics and Headache clinics.
Eligibility Criteria
This trial is for adolescents and adults aged 14-45 who suffer from headaches or neck pain after a head injury in the past year. Participants must have tried at least one treatment without success, such as migraine prevention meds, neuropathic pain meds, physical therapy, or cognitive-behavioral therapy. Those with significant psychological issues or unable to consent are excluded.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive either an occipital nerve block or a cervical medial branch block. If a >50% pain reduction is observed after four weeks, they may continue to receive blocks as needed, but not more than one every three months.
Follow-up
Participants are monitored for safety and effectiveness after treatment, with assessments of headache severity, frequency, and quality of life.
Treatment Details
Interventions
- Cervical Medial Branch Block (CMBB)
- Occipital Nerve Block (ONB)
Find a Clinic Near You
Who Is Running the Clinical Trial?
Boston Children's Hospital
Lead Sponsor
Harvard University
Collaborator
Beth Israel Deaconess Medical Center
Collaborator