Stellate Ganglion Blockade for Refractory Chronic Migraine

Stellate Ganglion Block (SGB) is an interventional anesthetic technique used to treat pain conditions affecting the head, face, neck, and upper extremities by temporarily blocking sympathetic nerve output. Ultrasound guidance improves anatomical visualization and facilitates accurate needle placement. Emerging evidence suggests that repeated ultrasound-guided SGB may be associated with reductions in headache intensity and frequency in patients with migraine and with improvement in migraine-related disability. However, limited data exist regarding its use in highly treatment-resistant chronic migraine, particularly in patients who have not responded adequately to preventive pharmacological therapies and prior interventional treatments. The primary objective of this study is to evaluate 6-month clinical outcomes following ultrasound-guided SGB in patients with treatment-resistant chronic migraine. Secondary objectives include assessing changes in pain intensity, migraine-related disability, analgesic use, patient-reported global improvement, and treatment tolerability.