Greater Occipital Nerve Pulsed Radiofrequency for the Treatment of Combined Migraine and Cervicogenic Headache (New Approach)

Study Overview
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Brief Summary
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Combined migraine and cervicogenic headache present significant challenges in clinical management due to their complex and overlapping pathophysiologies. Both conditions involve the trigeminocervical complex, suggesting a potential shared anatomical and neurobiological basis

Detailed Description
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Traditional treatment approaches for these headaches often include pharmacological interventions, but in cases of refractory or inadequate response, interventional techniques targeting the greater occipital nerve (GON) have gained attention. Radiofrequency ablation (RFA) has gained recognition as a potential therapeutic option for patients with refractory combined migraine and cervicogenic headaches. The proximal and distal ultrasound-guided approaches are widely utilized for GON RFA. These approaches aim to disrupt pain signals transmitted by the GON and provide relief of pain for these headache disorders

Official Title
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Greater Occipital Nerve Pulsed Radiofrequency for the Treatment of Combined Migraine and Cervicogenic Headache (New Approach): Randomized Clinical Trial

Conditions
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Greater Occipital Nerve, Pulsed Radiofrequency

Intervention / Treatment
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* Procedure: proximal ultrasound-guided GON radiofrequency ablation
* Procedure: distal ultrasound-guided GON radiofrequency ablation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients diagnosed with combined migraine and cervicogenic headache according to The International Classification of Headache Disorders (ICHD) Age between 18 and 65 years. Willingness to participate and provide informed consent Exclusion Criteria: Previous neurosurgical procedures for headache management. Patients with contraindications for the RF technique Pregnancy or lactation History of psychiatric disorders or substance abuse

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Proximal group<br>proximal ultrasound-guided GON radiofrequency ablation | Procedure: proximal ultrasound-guided GON radiofrequency ablation<br>* proximal GON radiofrequency<br>|
| Experimental: Distal group<br>distal ultrasound-guided GON radiofrequency ablation | Procedure: distal ultrasound-guided GON radiofrequency ablation<br>* distal GON radiofrequency<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numerical rating score | 0-10 scale, with 0 indicating no pain and 10 indicating the worst possible pain. | baseline and at follow-up visits (2 weeks.1, 2.3, and 6 months) |