Assessment of the Efficacy of the Transnasal Sphenopalatine Ganglion Block in the Treatment of Chronic Daily Headache in Children and Adolescents. (SPG)
Chronic Daily Headache, Post-Traumatic Headache
About this trial
This is an interventional treatment trial for Chronic Daily Headache
Eligibility Criteria
Inclusion Criteria:
Subjects will be included if they meet all the following criteria:
- Aged between 10 and 17.5 years old at the start of treatment
Daily Headache, within these categories:
- Persistent PTH attributed to Mild traumatic Brain injury to the head
Diagnostic criteria for persistent headache attributed to mild traumatic injury to the head:
Persistent headache attributed to traumatic injury to the head:
A. Any headache fulfilling criteria C and D B. Traumatic injury to the head1 has occurred
C. Headache is reported to have developed within 7 days after one of the following:
- Injury to the head
- Regaining of consciousness following injury to the head
- Discontinuation of medication(s) impairing ability to sense or report headache following injury to the head D. Headache persists for >3 months after its onset E. Not better accounted for by another ICHD-3 diagnosis Persistent headache attributed to mild traumatic injury to the head A. Headache fulfilling criteria for 5.2 Persistent headache attributed to traumatic injury to the head
B. Head injury fulfilling both of the following:
Associated with none of the following:
- Loss of consciousness for >30 minutes
- Glasgow Coma Scale (GCS) score <13
- Post-traumatic amnesia lasting >24 hours1
- Altered level of awareness for >24 hours
- Imaging evidence of a traumatic head injury such as skull fracture, intracranial hemorrhage and/or brain contusion
Associated with one or more of the following symptoms and/or signs:
- Transient confusion, disorientation or impaired consciousness
- Loss of memory for events immediately before or after the head injury
- Two or more of the following symptoms suggestive of mild traumatic brain injury:
- Nausea
- Vomiting
- Visual disturbances
- Dizziness and/or vertigo
- Gait and/or postural imbalance
- Impaired memory and/or concentration
Exclusion Criteria:
- Previous history of brain imaging showing evidence of intracerebral hemorrhage, subdural or epidural hematomas, or subarachnoid hemorrhage as a consequence of traumatic head injury
- Previous history of local anesthetic allergic reaction to bupivacaine
- Nasal septal deformity or malformed facial or nasal passages such as cleft lip and palate, choanal atresia, atrophic rhinitis, rhinitis medicamentosa, septal perforation, deviation of the nasal septum, nasal/midface trauma or if he has recently had nasal/sinus surgery
- Nasal or facial fracture impeding the use of TX360 device
- Serious infection with congestion more than 10 days, and rectal temperature higher than 38°C for more than 1 day9.
- Current diagnose of bleeding disorder or recurrent untreated (> 3/week) nosebleeds for the past 3 months
- Severe respiratory distress, as noted by tachypnea or subcostal/intercostal retractions in when breathing
- Angiofibroma, sinus tumors, or granuloma
- Diagnosed or strongly suspected paroxysmal hemicrania or hemicrania continua
- Pregnancy before the completion of the last dose
- The possibility of a medication overuse headache is NOT an exclusion criterion, as long as the headache also corresponds to the inclusion criteria.
Sites / Locations
- McGill University Health Centre (MUHC) - Montreal Children's Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Treatment Arm
Placebo Arm
The participants randomized into this arm will receive the SPG block with 0.5% bupivacaine.
The participants randomized into this arm will receive the SPG block with saline.