Surgery for migraine headaches
Some nerves in the head and neck can be compressed or irritated, and act as trigger sites for headaches. These nerves can be compressed by muscles, blood vessels, fascia, or even bone.
This nerve compression can cause the nerve to release painful signals that travel to the brain and trigger a migraine headache.
How do nerves in the head and neck cause migraines?
What is surgery for migraines?
The purpose of migraine surgery is to decompress the nerves involved in trigger sites. This means that any muscles, fascia, blood vessels or bone that are compressing the nerve are removed, allowing the nerve to be free of compression or irritation
In the brow/forehead region, the supraorbital nerve (SON) and supratrochlear nerve (STN) can be compressed by the corrugator muscle (a muscle that helps with frowning), as well as blood vessels, and even a foramen (hole in the bone) through which the nerves sometimes travel
To decompress the SON and STN, Dr. Khansa will remove the corrugator muscle, release any foramina or notches, and ligate any blood vessels compressing the nerves
In the back of the neck, the greater occipital nerve (GON), third occipital nerve (TON) and lesser occipital nerve (LON) may be compressed by muscles, blood vessels or fascia
To treat GON compression, Dr. Khansa will remove portions of trapezius and semispinalis muscle and fascia, and will ligate the occipital artery if it compresses the nerve.
To treat LON and TON compression, Dr. Khansa will release them from any surrounding muscle and fascia, or will ligate them
In the temple, the zygomaticotemporal nerve (ZTN) and auriculotemporal nerve (AT) may be compressed by muscles or blood vessels
To treat AT nerve compression, Dr. Khansa will remove any portion of the superficial temporal artery compressing the nerve, and may ligate the nerve
To treat ZTN compression, Dr. Khansa will ligate the nerve
When the septum is deviated and touches the inferior turbinates on the side of the nose, nerves inside the nose may be irritated, triggering migraine headaches
To treat mucosal contact points in the nose, Dr. Khansa will perform a septoplasty and a turbinate reduction
What is the evidence that surgery helps migraine headaches?
Many studies have demonstrated that, in carefully selected patients, surgery for migraine significantly reduces headache intensity, frequency and duration
A Placebo-Controlled Surgical Trial of the Treatment of Migraine Headaches
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