Turkish Journal of Anaesthesiology & Reanimation

Sphenopalatine Ganglion Block for Headache Treatment After an Incidental Durotomy: A Case Report


Department of Anaesthesiology, Centro Hospitalar de Vila Nova de Gaia (CHVNG), Vila Nova de Gaia, Portugal


Department of Neurosurgery, Centro Hospitalar de Vila Nova de Gaia (CHVNG), Vila Nova de Gaia, Portugal

Turk J Anaesthesiol Reanim 2023; 51: 72-74
DOI: 10.5152/TJAR.2023.21634
Read: 84 Downloads: 35 Published: 01 February 2023

Incidental durotomy is the most common intraoperative complication of spine surgeries. Our main goal is to report a case of a postoperative postdural puncture headache following an incidental durotomy successfully managed with a sphenopalatine ganglion block. A 75-year-old woman, American Society of Anesthesiologists physical status II, proposed for a lumbar interbody fusion. During surgery, an incidental durotomy with cerebrospinal fluid leak occurred, being repaired with muscle and DuraSeal® Dural Sealant System. In the recovery room, 1 hour after the end of the surgery, the patient developed a severe headache associated with nausea and photophobia. A bilateral transnasal sphenopalatine ganglion block with 0.75% ropivacaine was performed. Immediate pain relief was verified. The patient reported only mild headaches on the first postoperative day, feeling progressively better until discharge. The sphenopalatine ganglion block may be an effective alternative treatment for postdural puncture headache following an incidental durotomy during neurosurgeries. Sphenopalatine ganglion block may be a safe, lowrisk alternative in the treatment of postdural puncture headache after an incidental durotomy that can be used in the immediate postoperative period to enable early recovery and return to day-to-day activities, which will hopefully lead to better surgical outcomes and patient satisfaction.

Cite this article as: Marques A, Morais I, Costa V, Romão H. Sphenopalatine ganglion block for headache treatment after an incidental durotomy: A case report. Turk J Anaesthesiol Reanim. 2023;51(1):72-74.

EISSN 2667-6370