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Migraine Surgery

What is Migraine Surgery?

Migraine surgery is a medical procedure aimed at reducing or preventing migraine headaches. It often involves surgical decompression of specific nerves in the head and neck which are identified as migraine triggers by removing small sections of bone or tissue pressing on the nerves or cutting the nerves themselves. 

What is the Patient Selection Criteria for Migraine Surgery?

You might be a candidate for migraine surgery if you meet the following criteria:

  • Chronic Migraine: You experience frequent migraines (15 or more headache days per month) that significantly impair your quality of life.
  • Failed Conservative Treatments: You have not achieved adequate relief from medications, lifestyle modifications, and other non-surgical interventions.
  • Specific Trigger Sites: Migraine surgery is most effective if your headaches are localized to specific trigger sites, such as the forehead, temples, or occipital region.

How do you Prepare for Migraine Surgery?

Preparation for migraine surgery typically involves a medical evaluation, lab testing, and specific instructions from your healthcare provider. You may need to adjust current medications, stop smoking, and avoid aspirin, anti-inflammatory drugs, and herbal supplements due to increased bleeding risk.

What are the Surgical Approaches for Migraine Surgery?

Surgical approaches for migraine relief include:

  • Frontal Migraine Surgery: Also known as frontal trigger site deactivation, this procedure involves the identification and decompression of nerves in the frontal region of the scalp that are believed to contribute to migraine headaches. Common techniques include supraorbital nerve decompression and removal of trigger muscle tissue.
  • Temporal Migraine Surgery: Temporal trigger site deactivation targets nerves and muscle tissue in the temporal region of the head. Surgical techniques may include decompression of the zygomaticotemporal nerve and resection of the temporalis muscle.
  • Occipital Migraine Surgery: Occipital trigger site deactivation aims to relieve migraine symptoms originating from the occipital nerves at the base of the skull. Surgical approaches may involve decompression of the greater occipital nerve and surrounding tissues.

What are the Outcomes of Migraine Surgery?

The efficacy of migraine surgery varies among patients, with some experiencing significant reduction or elimination of migraine symptoms, while others may only achieve partial relief. Studies have reported success rates ranging from 50% to 90%, depending on the surgical technique and patient population. 

Recovery after Migraine Surgery

The procedure is typically outpatient, with possible overnight hospital stay. Incisions are discreet. Showering is allowed after 2 days at home. Work may resume in 2 weeks, though heavy lifting might be restricted for 3 weeks. Follow-up visits could continue for a year.

What are the Complications of Migraine Surgery?

Common complications associated with migraine surgery include temporary numbness, pain at the surgical site, and potential recurrence of migraines. Serious complications such as infection, nerve injury, and scarring are rare but possible.

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