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Decompression Surgery for Frontal Migraine Headache.

Maria Lucia Mangialardi¹, Ilaria Baldelli², Marzia Salgarello¹

¹Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore e Unità di Chirurgia Plastica, Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy.

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|November 11, 2020

Summary

Surgical treatment, specifically frontal trigger site nerve decompression, offers a promising option for patients with refractory migraines unresponsive to traditional pharmaceutical management. This approach can significantly improve symptoms for a considerable percentage of individuals.

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Area of Science:

Neurosurgery
Pain Management
Neurology

Background:

Migraine headache (MH) affects a significant portion of the global population, with pharmaceutical treatments being the standard of care.
Approximately one-third of migraine patients are refractory to medical management, necessitating alternative treatment strategies.
Surgical intervention is explored as a supplementary option for refractory migraine headaches when pharmaceutical treatments yield unsatisfactory results.

Purpose of the Study:

To conduct a comprehensive literature review on the surgical treatment of migraine headaches, focusing on Site I management.
To evaluate the efficacy of surgical interventions for refractory migraine patients.

Main Methods:

A systematic literature search was performed across PubMed, Medline, Cochrane, and Google Scholar databases.
The search utilized MeSH terms including "frontal neuralgia," "frontal trigger site treatment," "frontal migraine surgery," and "frontal headache surgery" for studies published between 2000 and 2020.
The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Main Results:

Eighteen studies involving 628 patients, published between 2000 and 2019, were included in the review.
Satisfactory postoperative results were reported in 68% to 93% of patients.
Complete migraine elimination rates ranged from 28.3% to 59%, with significant improvement (>50% reduction) rates varying from 26.5% to 60%.

Conclusions:

Frontal trigger site nerve decompression appears to be an effective strategy for managing refractory migraines.
This surgical approach offers significant symptom improvement for a considerable percentage of patients.
The findings suggest that surgical intervention is a viable supplementary treatment for individuals with intractable migraine headaches.