The sphenopalatine ganglion (SPG) is a parasympathetic ganglion, located in the pterygopalatine fossa. The SPG block has been used for a long time for treating headaches of varying etiologies. For anesthesiologists, treating postdural puncture headaches (PDPH) has always been challenging. The epidural block patch (EBP) was the only option until researchers explored the role of the SPG block as a relatively simple and effective way to treat PDPH. Also, since the existing evidence proving the efficacy of the SPG block in PDPH is scarce, the block cannot be offered to all patients. EBP can be still considered if an SPG block is not able to alleviate pain due to PDPH.
Blood Patch, Epidural ; Ganglia, Parasympathetic ; Ganglion Cysts ; Headache ; Humans ; Pain Management ; Post-Dural Puncture Headache* ; Pterygopalatine Fossa ; Sphenopalatine Ganglion Block*

Cluster headaches are recurrent, unilateral attacks of severe pain that almost always occur on the same side of the head. They are oculofrontal or oculotemporal, with radiation to the upper jaw. The precise cause of cluster headaches are still unknown and treatments are very difficult. A 34 year old male patient suffering from severe classical cluster headache was refered to the pain clinic from department of neurosurgery. The patient complained of severe pain on right oculotemporal area and his symptoms had been refractory to any other treatment. His symptoms were effectively relieved after oxygen inhalation and sphenopalatine ganglion block with 4% lidocaine 2 ml during his attack. I could effectively prevent the attack of the cluster headache using stellate ganglion block (SGB) with 0.25% bupivacaine 5 ml twice daily during 3 weeks.
Adult ; Bupivacaine ; Cluster Headache* ; Head ; Humans ; Inhalation ; Jaw ; Lidocaine ; Male ; Neurosurgery ; Oxygen ; Pain Clinics ; Sphenopalatine Ganglion Block ; Stellate Ganglion*