Sphenopalatine ganglion (SPG):

  • Superficial extracranial PNS ganglion
  • Amenable to blockade via transanasal approach

Post dural puncture headaches (PDPH) due in part to PNS mediated cerebral vasodilation.

Blockade of ganglion may result in cerebral vasoconstriction and pain relief

Case studies demonstrate promising results in obstetric post dural puncture headaches (Cohen et al & Kent et al)
Block is simple, low risk and minimally invasive – Local anaesthetic solution on cotton bud passed into nasopharynx & left insitu for 10-30 minutes.

Should we considered this as a first line therapy in conjunction with conservative management for PDPH?

Transnasal Sphenopalatine Ganglion Block for the Treatment of Post Dural Puncture Headache Following Lumbar Puncture. Poster presentation 2015




Robbins, MR, Robertson, CE , Kaplan, E, Ailani, J, Charleston, L, Kuruvilla, D, Blumenfeld, A, Berliner, R, Rosen, N.L, Duarte, R, Vidwan, J, Halker, RB, Gill, N & Ashkenazi, A. The Sphenopalatine Ganglion: Anatomy, Pathophysiology, and Therapeutic Targeting in Headache. Headache. 2015;56:240-258