Chronic intractable headaches are one of the most frequent reasons for emergency room visits. The intense headache flare-ups can be controlled in ED; however, the emergency care has a great deal of frustration, which can be caused by time spent waiting to be treated, noise, and multiple tests ordered. The future of aggressive headache treatment is residing in a specialized clinic. This is a far more cost-and time-effective model of care for intractable chronic headaches, including migraine.
Intravenous treatment requires a nursing staff trained in IV therapy to monitor vital signes, administer oxygen, and add necessary medications. A pain management specialist, experienced in headache, oversees the entire process. Patients are treated in private rooms with dimmed light. The exact IV concoction is ordered by a physician and based on the specific headache diagnosis. The list of possible ingredients includes ketamine, lidocaine, dexamethasone, metoclopramide, magnesium, and others. We will often recommend vitamins and microelements infusions to further help with balancing functional disturbances that amplify headaches. The clinical experience is suggestive of high effectiveness of the infusion therapy with more than 90% of patients experiencing decrease in severity of the presenting headache by 50%.