Background Intranasal evaporative cooling due to vascular anatomy, allows the transfer of venous blood from nasal and paranasal mucous membranes to the dura mater, providing an excellent anatomical basis for the cooling processes. The aim of this study was to ascertain whether it may be an effective intervention in an acute migraine attack.

Methods We conducted a prospective, open-label, observational, pilot study. A total of 20 treatments were administered in 15 patients who satisfied the ICHD 2 diagnostic criteria for migraine. All patients provided pain and migraine-associated symptoms severity scores.

Results Immediately after the treatment, 8 treatments (40%) resulted in pain and symptoms freedom, a further 10 treatments (50%) resulted in partial pain and symptoms relief. At 2 hours, 9 treatments (45%) provided full pain and symptoms relief, with a further 9 treatments (45%) resulting in partial pain and symptoms relief. In summary 13 patients (87%) had benefit from the treatment within 2 hours that was sustained at 24 hours; without significant side effects.

Conclusions Intranasal evaporative cooling was safe and gave considerable benefit to patients with migraine. An adequately powered randomised controlled study will be required to confirm the potential of this application in the treatment of migraine.