Greater occipital nerve block to relieve headaches from spontaneous intracranial hypotension
Official title: Role of Greater Occipital Nerve Block in Headache From Spontaneous Intracranial Hypotension: a Prospective Observational Study
Run by University Health Network, Toronto · NCT06374524 · Data updated 2026-11-12
This will try a bilateral ultrasound-guided greater occipital nerve block in adults with spontaneous intracranial hypotension to see if it quickly reduces upright headache.
Quick facts
| Study type | Observational |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 34 (estimated) |
| Sponsor | University Health Network, Toronto Academic / other |
| Locations | 1 site (Toronto, Ontario) |
| Status | Recruiting |
| Started | August 1, 2024 |
| Main results expected | December 31, 2027 |
| Study ends | December 31, 2027 |
| Registry record updated | January 16, 2026 |
| Trial ID | NCT06374524 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults (over 18) with a diagnosis of spontaneous intracranial hypotension by ICHD-3 criteria who have upright pain intensity greater than 4/10 and no contraindications to the injection are ideal candidates.
✕Probably not a fit
Patients with contraindications to injection (active infection, allergy, steroid contraindication), those on high-dose opioids (OME ≥50 mg/day), or whose headache is not orthostatic are unlikely to receive benefit from this approach.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This is a prospective observational project enrolling 34 adults with spontaneous intracranial hypotension managed at a single tertiary center. Participants receive an ultrasound-guided bilateral greater occipital nerve block with a 5 mL injectate of local anesthetic plus steroid and there is no control group. The primary outcome is change in headache intensity 30 minutes after the injection, with secondary outcomes that track pain, onset time, sitting endurance, associated CNS symptoms, emotional functioning, patient satisfaction, analgesic use, and side effects through 14 days. The goal is to characterize short-term symptomatic benefit and safety while patients await definitive CSF-leak treatments.
Why it matters
Potential benefit: If successful, the injection could provide rapid short-term relief of orthostatic headache and improve sitting tolerance and daily function while awaiting definitive leak repair.
How similar studies have gone: Small case series and observational reports suggest occipital nerve blocks can provide short-lived headache relief in SIH and related headaches, but high-quality evidence is limited.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion criteria 1. Adults of \> 18 years of age 2. Diagnosis of SIH, according to the International Classification of Headache Disorder (ICHD-3) classification (2) 3. Characteristics of pain: 1. Baseline pain intensity NRS \> 4/10 (in upright position) Exclusion criteria 1. Contraindications to GONB: ongoing infection (systemic or located at the site of injection), intake of anticoagulants (not aspirin), allergy to injectate, contra-indication to injectate of steroids 2. Any significant cognitive or language barrier that impedes participation 3. Patients taking opioid medications with daily Oral Morphine Equivalent (OME) of 50 mg or higher 4. Patient refusal
Where it's running
-
Toronto Western Hospital
Toronto, Ontario, Canada Recruiting
Study contacts
- Study coordinator: Anna Kalleitner, RN
- Email: Anna.Kalleitner@uhn.ca
- Phone: 416-603-5800
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.