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Published on: May 10, 2017
Cluster headache and TACs: rationale for central and peripheral neuromodulation
G Broggi1, G Messina, A Franzini
1Department of Neurosurgery, Istituto Nazionale Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
Summary
This review explores surgical treatments for severe cluster headache and SUNCT headaches. It examines Deep Brain Stimulation, Occipital Nerve Stimulation, and Vagal Nerve Stimulation, considering their roles in managing these debilitating conditions.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Cluster headache and SUNCT are severe primary headache disorders causing significant functional and social impairment.
- Recent research has focused on understanding the underlying mechanisms and developing effective treatments.
Purpose of the Study:
- To review current knowledge on surgical interventions for drug-resistant cluster headache and SUNCT.
- To analyze the roles of different surgical approaches based on hypothesized pathological mechanisms.
Main Methods:
- Review of existing clinical, physiopathological, and neuroradiological studies.
- Analysis of surgical options including Deep Brain Stimulation (DBS), Occipital Nerve Stimulation (ONS), and Vagal Nerve Stimulation (VNS).
Main Results:
- Surgical options are being refined to target both central and peripheral nervous system contributions.
- DBS represents a central nervous system approach, while ONS and VNS are peripheral approaches.
Conclusions:
- Surgical treatments offer potential therapeutic avenues for intractable cluster headache and SUNCT.
- Understanding the distinct mechanisms of each surgical option is crucial for effective patient management.
