{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T15:05:20Z","timestamp":1789571120089,"version":"build-2803163510"},"reference-count":34,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronic migraine (CM) remains a major cause of neurological disability, and a subset of patients remains highly treatment-resistant despite previous preventive and interventional treatments. Stellate ganglion block (SGB) has been proposed as a sympathetic neuromodulatory intervention, but evidence in this population remains limited. This study evaluated 6-month clinical outcomes and tolerability after a structured ultrasound-guided SGB protocol. Materials and Methods: This prospective, single-center, uncontrolled, single-group interventional study enrolled 42 adults with CM who had experienced insufficient benefit from prior preventive migraine treatment and previous interventional headache procedures. After an initial ultrasound-guided SGB to assess anatomical suitability and procedural tolerability, all participants proceeded to four additional weekly ultrasound-guided SGB sessions using 5 mL of 1% lidocaine, for five protocol-defined sessions in total. The primary outcome was the change in monthly headache days (MHD) from baseline to 6 months. Results: All 42 participants (mean age: 44.4 \u00b1 7.4 years) completed the 6-month follow-up. Median MHD decreased from 29.0 days at baseline to 6.0 days at 6 months (Kendall\u2019s W = 0.643, p &lt; 0.001), corresponding to a median within-participant reduction of 17.0 days (BCa 95% CI: 13.0\u201319.0). A \u226550% reduction in MHD was achieved by 73.8% of participants (95% CI: 58.9\u201384.7) at 6 months, whereas 14.3% (95% CI: 6.7\u201327.8) achieved a \u226550% reduction in mean pain intensity. HIT-6 and MIDAS scores also improved significantly (p &lt; 0.001). Six participants (14.3%) reported mild, self-limited adverse effects; no serious adverse events were documented. Conclusions: Ultrasound-guided SGB was associated with sustained reductions in headache frequency, analgesic use, and migraine-related disability over 6 months. Because this was an uncontrolled single-group study, the findings should be considered preliminary and hypothesis-generating. The frequency-dominant pattern of improvement and favorable tolerability support further controlled evaluation of SGB as a potential adjunctive neuromodulatory strategy in highly treatment-resistant CM.<\/jats:p>","DOI":"10.3390\/medicina62091784","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:50:27Z","timestamp":1789566627000},"page":"1784","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes of Ultrasound-Guided Stellate Ganglion Block in Highly Treatment-Resistant Chronic Migraine: A 6-Month Prospective Single-Group Interventional Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4204-4530","authenticated-orcid":false,"given":"Sukriye","family":"Dadali","sequence":"first","affiliation":[{"name":"Department of Pain Medicine, Ankara Bilkent City Hospital, Ankara 06800, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Emel","family":"Basar","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, Giresun Training and Research Hospital, Giresun 28100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9031-2088","authenticated-orcid":false,"given":"Ulku","family":"Sabuncu","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, Ankara Bilkent City Hospital, Ankara 06800, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1461-4092","authenticated-orcid":false,"given":"Gulcin","family":"Babaoglu","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, Ankara Bilkent City Hospital, Ankara 06800, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4383-0146","authenticated-orcid":false,"given":"Ali","family":"Costu","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, Ankara Bilkent City Hospital, Ankara 06800, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Erkan Yavuz","family":"Akcaboy","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, Ankara Bilkent City Hospital, Ankara 06800, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Headache Classification Committee of the International Headache Society (IHS) (2018). 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