Migraine Surgery – What You Need to Know
Migraine
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Chronic migraine sufferers already understand the severe impact these headaches have on their lives. Several treatments including drugs and lifestyle adjustments fail to eliminate your symptoms, while continuous severe headaches create daily struggles.
Migraine surgery can deliver a long-lasting resolution for certain patients. Migraine surgery serves as a beneficial solution for numerous patients who found no success with other treatments. Today, we’ll help you make a well-informed decision about whether this treatment option could work for you.
What is Migraine Surgery?
Through precise medical intervention, migraine surgery aims to alleviate chronic headaches by targeting root causes like nerve compression or irritation. People experiencing regular severe migraines should consider migraine surgery as their final option for better life quality.
The surgical technique operates on the principle that migraine headaches stem from the compression or irritation of specific nerves by nearby muscles, blood vessels, or other anatomical structures. Compression of these nerves can activate the pain and different symptoms linked to migraines. Migraine surgery aims to alleviate nerve compression and irritation to decrease migraine frequency and intensity or eliminate headaches entirely.
Who is a Candidate for Migraine Surgery?
Healthcare providers consider migraine surgery as an option for patients with chronic migraines when existing treatments fail to control their symptoms. Chronic migraines represent headaches that happen on 15 or more days each month and remain consistent throughout three months or longer. The severe symptoms these individuals face include debilitating pain, nausea, and sensitivity to light or sound which significantly reduce their quality of life.
When medications, Botox injections, lifestyle adjustments, and alternative treatments fail to relieve symptoms, surgery becomes a possible treatment option for these patients. People who qualify for migraine surgery usually have a long history of migraines and exhibit chronic or frequent migraine patterns.
People who did not find relief through numerous treatments such as over-the-counter pain medications and prescription medications are included in this patient population. These treatments provide temporary relief for many patients, yet fail to eliminate the underlying causes of migraines. This leads to the consideration of surgery as a permanent solution.
General health status and age both serve as major criteria when determining eligibility for migraine surgery. Migraine surgery can be done on adults at any age, but doctors usually avoid this procedure for younger people who have not yet become adults.
Potential candidates need to maintain good health so they can safely receive both anesthesia and surgical procedures without major risks. Medical professionals should thoroughly assess patients who have serious health conditions before surgery. This is due to their existing illnesses such as heart disease or diabetes, which can cause complications.
How is Migraine Surgery Performed?
The migraine surgery procedure helps patients with chronic migraines who found no success with other treatments achieve relief. Through migraine surgery, physicians address migraine triggers including nerve compression by either removing or modifying structures that irritate or compress the pain-triggering nerves. The two main forms of migraine surgery include nerve decompression surgery and occipital nerve stimulation (ONS).
Nerve decompression surgery aims to alleviate chronic migraine pain by reducing pressure on affected nerves. Patients whose migraines originate from anatomical issues like nerve compression or irritation in their head, neck, or face areas, typically undergo this procedure. The surgical procedure involves surgeons removing or modifying adjacent tissues to reduce nerve pressure.
Surgeons usually target the occipital nerve at the back of the head along with the temporal nerve near the forehead and the supraorbital nerve, which crosses the brow during nerve decompression procedures. The procedure starts with a consultation and imaging tests that pinpoint the specific head and neck nerves, which could be triggering migraine pain.
Patients usually receive general anesthesia after agreeing on the surgical approach, but local anesthesia becomes an option for certain procedures. Depending on the specific nerves that need to be reached during surgery, the surgeon creates small precise incisions either on the scalp, forehead, or neck.
The surgical technique involves creating an incision along the hairline to access the occipital nerve or making a cut near the temples to access the temporal nerve. After the incisions are made, the surgeon precisely locates the targeted nerves and liberates any surrounding muscles and connective tissues that might result in pressure or irritation. The surgeon may need to extract small muscle or fatty tissue sections to decrease compression further in some situations.
The procedure aims to restore normal nerve function free from interference, which results in substantial decreases in migraine attack frequency and intensity. Upon finishing the decompression process, the surgical team sews the incisions before transferring the patient to the recovery area.
The treatment method known as occipital nerve stimulation (ONS) offers a minimally invasive technique that focuses on regulating nerve signals to lower migraine pain. A small device gets implanted under the skin at the back of the head to send electrical pulses to the occipital nerves that transmit headache pain.
The implantation process consists of two steps, beginning with the placement of a temporary lead under the skin near the occipital nerve. The patient will receive the permanent implant if their response to the trial proves positive.
The procedure begins with local anesthesia administered to the patient before the surgeon creates a tiny opening in the back of the head to reach the occipital nerve. A thin wire, known as a lead, is positioned beside the nerve and connected to an external stimulator. This enables the patient to experience brief electrical stimulation.
The “trial phase” serves to determine if the device will deliver the expected relief. After the patient reports notable migraine symptom relief during this trial phase, doctors will proceed to the second stage that involves permanent device implantation.
The second phase involves permanent placement of the lead under the skin followed by the implantation of the pulse generator just beneath the skin in a discreet location. The device receives power from the lead and delivers a low-level electrical current to stimulate the occipital nerve.
A rechargeable pulse generator allows time-based adjustments to maximise migraine relief. After implantation of the device, surgeons close the incisions using sutures while healthcare providers monitor the patient throughout the recovery period.
Recovery After Migraine Surgery
Patients who undergo migraine surgery experience recovery times that depend on the specific procedure they have received. Nerve decompression surgery and occipital nerve stimulation (ONS) represent the two primary migraine surgery options. These options both require specific recovery paths, yet incorporate common aspects such as pain control and progress monitoring.
The recovery process starts at once after nerve decompression surgery while the patient remains under observation in a recovery room until anesthesia effects disappear. During the initial post-surgery days, the primary focus remains on pain management and complication prevention. Patients often experience swelling and bruising with some tenderness near the surgical area when operations involve visible sites such as the forehead or scalp.
Patients receive pain medication to alleviate soreness while they recover from surgery. They are instructed to rest and limit physical activity during the early recovery phase. Patients usually resume their regular activities after one to two weeks, but should refrain from lifting heavy items and undertaking any activities that might stress the surgical area.
Patients are usually advised to walk gently because it helps blood flow and lowers blood clot formation risks. There may be mild to moderate swelling or numbness at the incision sites during the first few weeks following surgery which usually clears up over time. Patients will also receive instructions to maintain their surgical site hygiene by keeping it clean and dry.
Patients who undergo occipital nerve stimulation (ONS) recover faster than those who have nerve decompression surgery. Medical professionals monitor the patient for several hours after placing a temporary lead during the initial procedure to confirm the stimulator relieves migraine symptoms. Upon successful completion of the trial period, the patient receives permanent implantation of the device through an outpatient procedure.
Patients experience faster recovery after permanent stimulator implantation and typically resume normal activities within one to two weeks.
Migraine Surgery: FAQ
1. What is migraine surgery?
Migraine surgery normally includes the release or inactivation of specific trigger points or nerves that cause chronic migraine pain. The standard surgical options for migraine treatment include nerve decompression surgery and occipital nerve stimulation (ONS).
2. How is the surgery performed?
Surgeons perform nerve decompression through tiny cuts in the scalp, forehead, or neck to relieve pressure from compressed nerves. Patients receive either local or general anesthesia during the procedure. The treatment method of occipital nerve stimulation employs an implanted device beneath the skin that sends electrical pulses to the occipital nerves to disrupt headache signals.
3. How long is the recovery process?
Patients who undergo nerve decompression surgery often notice swelling or bruising, yet can resume normal activities within a one to two-week timeframe. Patients who undergo occipital nerve stimulation generally return to their normal activities within one to two weeks, but need additional time to adjust stimulation settings for full effectiveness.
