In a bid to treat the severe headaches often following a stroke, the University of Cincinnati is trialing non-opioid remedies as part of a larger nationwide clinical trial. The University of Cincinnati News reported on this initiative, which is focused on post-subarachnoid hemorrhage (SAH) pain, a form of stroke impacting an estimated 30,000 Americans annually.
Dr. Charles Prestigiacomo, the site principal investigator for the BLOCK-SAH trial and a reputable figure in cerebrovascular and endovascular neurosurgery at UC's College of Medicine, is at the helm of this research. "Nearly all SAH patients experience headaches of varying intensity, and in about 90%, headaches are severe," Prestigiacomo told University of Cincinnati News. The headaches are often severe enough to bring patients back to the emergency room, signaling the need for better pain management methods.
The current standard for treating SAH involves stabilizing the ruptured aneurysm to prevent further bleeding. However, the control of ensuing headaches has largely been dependent on opioids, which carry a well-documented risk of dependency and a slew of side effects. The BLOCK-SAH trial aims to change that by utilizing a numbing agent, ropivacaine, coupled with dexamethasone, an anti-inflammatory steroid. The intended result is to mitigate or eliminate the need for opioids in addressing headache pain post-stroke.
As part of the treatment, these drugs are injected into the pterygopalatine fossa, targeting the nerve center that affects sensations along the scalp and brain linings. "Several prior studies have shown that by numbing this collection of nerve cells, headaches and their effects are reduced and at times eliminated," said Prestigiacomo, in a statement obtained by University of Cincinnati News. The trial will include around 195 participants across the nation, with UC enrolling about 10 to 12 patients.
With the trial's primary goal set on reducing opioid use within 24 hours of the injection, secondary objectives include lowering pain intensity scores and assessing the safety of the technique, as well as exploring potential improvements in blood vessel imaging. If successful, this could mark a significant advancement in the treatment of one of the most common and distressing symptoms suffered by SAH patients.
