Nummular Headache and Its Surgical Treatment

Area of Science:

• Neurology
• Neurosurgery

Background:

• Nummular headache (NH) is a rare primary headache disorder causing localized scalp pain.
• Its extracranial origin is the leading theory, supported by overlapping symptoms with secondary NH forms.
• Despite accepted theories, effective treatments for NH remain elusive.

Purpose of the Study:

• To evaluate the efficacy of surgical strategies for treating nummular headache.
• To analyze outcomes for both primary and secondary NH following peripheral surgery.

Main Methods:

• A systematic literature review adhering to PRISMA guidelines was performed.
• Studies included English-language articles on primary or secondary NH treated with peripheral surgery and a minimum 3-month follow-up.

Main Results:

• Four studies involving 53 patients (50 with primary NH) were included.
• Approximately 70% of primary NH patients reported over 50% pain reduction post-surgery.
• All secondary NH patients achieved complete pain relief, though surgical approaches varied.

Conclusions:

• Neurovascular interactions in extracranial tissues appear implicated in NH onset.
• Limited data from few patients necessitates further investigation.
• Multicenter research protocols are crucial for advancing NH treatment understanding.