Neurology Advisor (in “Headache and Migraine Advisor” section) has recently published an update on the topic of persistent poststroke headache.  Overall, there is  an incidence of poststroke headache ranging from 9.3% to 38%.   Headache patterns have revealed  long-term, persistent headache(s)  as a distinct entity that warrants  entry as a new category in the International Classification of Headache Disorders (ICHD)-3.

This type of headache is ideally suited to be addressed with Sphenopalatine Ganglion Blocks.

Neurology advisor reports “The clinical utility of this new designation is not yet clear. “Acute stroke-related headache is not uncommon, reported in 23% to 54% of stroke patients,” Peter McAllister, MD, medical director of the New England Institute for Neurology and Headache and chief medical officer for the New England Institute for Clinical Research in Stamford, Connecticut, told Neurology Advisor. “It is often self-limited and resolves in days, weeks or a few months. Persistent poststroke headache is less well understood, other than we know, by definition, that it persists.”

There is a question as to whether a  persistent poststroke headache (PPSH) deserves a distinction as a primary headache.

Regardless of how a poststroke headache is classified it is treatment that is thee most important consideration.  Like many types of headaches including cluster headaches, migraines and chronic daily headache a first line approach that is very safe is a Spheenopalatine Ganglion Block or SPG Block.  The Sphenopalatine Ganglion Block has over a hundred year safety record in treating both headaches and migraines.

Headaches and migraines are primarily a function of the Trigeminal Nervous System and are modulated by the Limbic System and the Hypothalamus.  The Sphenopalatine Ganglion is the largest parasympathetic ganglion of the head and the sympathetic fibers arising from the superior cervical chain also pass thru the SPG and these sympathetic and parasympathetiic fibers travel along the trigeminal nerves to the brain along with the trigeminal somatosensory nerves.  Therse are amplified in the reticular activating system as they ascend into the brain.

Self-Administration pf SPG Blocks is extremely effective in many types of headaches and migraines and have also been utilized in poststroke headaches.

The elegance of Self-Administered SPG Blocks (SASPG Blocks) is that they are relatively non-invasive, can be self administered as needed (prn) can reduce hypertension often associated with strokes and anxiety a frequent side effect of stroke.

SASPG Blocks are cost effective and allow patients to avoid unnecessary trips to physicians offices and to emergency departments where needless testing is likely to occur.

Several patient testimonials on Self-Administered SPG Blocks are available at the following link to Reddit.

These are patients of Dr Shapira.

Visit Dr Shapira’s website to learn more:





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