Surgery May Be the Best Option for Severe Migraine Headaches

A new study shows that treating migraine trigger sites by local surgery could potentially cure migraine headaches.

Researchers at Case Western Reserve University School of Medicine (CSR, Cleveland, OH, USA) followed 79 migraine sufferers for at least five years, after having undergone detection of migraine "trigger sites" and subsequent surgery. Since the surgery, 10 of the 79 patients required additional surgeries for newly detected trigger sites and were eliminated from the final analysis. Sixty-one of the remaining 69 patients (88%) maintained the initial positive response to the surgery. Twenty patients (29%) reported elimination of migraines entirely, 41 patients (59%) noticed a significant decrease, and only eight patients (11%) experienced less than 50% improvement or no change. The study was presented at the American Society of Plastic Surgeons annual meeting, held during October 2009 in Seattle (WA, USA).

"Migraine headaches are extremely disabling and this surgical option offers hope for migraine sufferers,” said study presenter Bahman Guyuron, M.D., chairman of the plastic surgery department at CSR. "Combined with the previous studies, this new five-year data has provided strong evidence that severe migraine headaches and their painful symptoms can be successfully treated with surgery with lasting results.”

The surgical procedure involves removal of the muscle groups that are suspected of being a trigger point for headaches by compressing nerves and causing nerve inflammation. For frontal migraine headaches, this involves the corrugator supercilii (frowning) muscle group in the forehead. Temple migraine headaches are treated by removing a small branch of the trigeminal nerve. For those patients who suffer from occipital (back of the head) migraine headaches, a small piece of muscle encasing the nerve is removed and replace with a soft tissue flap. When the headaches are located behind eyes and are triggered by weather change, the nose septum and surrounding structures are treated.

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Case Western Reserve University School of Medicine