The efficacy of Gasserian ganglion block and pulsed radiofrequency in the treatment of chronic cluster headache: A retrospective cohort study

Background and purpose: To assess the effectiveness of Gasserian ganglion block and pulsed radiofrequency in managing chronic cluster headache (CCH). Methods: We enrolled 38 patients with treatment-resistant CCH who were admitted between March 2020 and January 2024 and underwent Gasserian ganglion pulsed radiofrequency (PRF) combined with a ganglion block. Patients were followed up for six months, with pain severity assessed using the 0-10 Numerical Pain Rating Scale (NPRS). Results: Among 38 patients (mean age 30.8 ± 8.6 years), the mean headache duration before treatment was 29.72 ± 17.65 months, and patients reported an average of 19.11 ± 2.01 headache days per month. Before the procedure, the mean NPRS score was 8.81 ± 0.80, which significantly decreased to 4.13 ± 3.74 post-treatment (p=0.001) and further declined to 3.38 ± 1.59 at the six-month follow-up (p=0.002). Four patients became pain-free, while 13 did not benefit from the procedure. The mean number of headache days dropped to 6.40 ± 4.22 per month (p. Conclusion: Our results showed a significant reduction in pain and attack frequency with Gasserian ganglion block and PRF for treating CCH resistant to standard therapies, with many patients requiring less medication. The procedure was well-tolerated, with mild and temporary side effects; these findings suggest it may be a promising option for drug-resistant CCH. Future studies should include controlled trials for further evaluation.