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Trigger areas nerve decompression for refractory chronic migraine.

Guiwen Chen1, Hengxing You1, Hernesniemi Juha2

  • 1Department of neurosurgery, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, Guangdong Province, China.

Clinical Neurology and Neurosurgery
|May 31, 2021
PubMed
Summary

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This summary is machine-generated.

Scalp nerve decompression offers a feasible treatment for chronic migraine (CM) refractory to medication. This surgical approach demonstrated significant success, with over 80% of patients experiencing symptom relief or cure.

Area of Science:

  • Neurology
  • Neurosurgery
  • Pain Management

Background:

  • Chronic migraine (CM) is a debilitating neurological disorder causing significant disability and reduced quality of life.
  • Medical treatments for refractory CM often yield limited success, necessitating alternative therapeutic strategies.

Purpose of the Study:

  • To assess the feasibility and efficacy of scalp nerve decompression in patients with chronic migraine unresponsive to conventional therapies.
  • To evaluate surgical outcomes for trigger site nerve decompression targeting supraorbital, auriculotemporal, and greater occipital nerves.

Main Methods:

  • Retrospective analysis of 154 patients with chronic migraine undergoing trigger site nerve decompression between January 2005 and January 2020.
  • Surgical procedures involved releasing affected nerves (frontal, temporal, occipital) from surrounding adhesions and vascular conflicts under local anesthesia.
Keywords:
Chronic migraineHeadachesRefractory migraineSurgeryTrigger nerve decompression

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Main Results:

  • The majority of patients (59.09%) underwent auriculotemporal nerve decompression.
  • At 1-year follow-up, 62.2% of patients were cured, and 18.83% reported symptom improvement, indicating an overall success rate of 81.03% for nerve decompression.
  • Partial remission was observed in 13.64% of patients, with 3.25% experiencing no change.

Conclusions:

  • Scalp nerve decompression is a viable treatment option for medically refractory chronic migraine.
  • The surgical intervention, targeting specific trigger sites, demonstrates a high success rate in alleviating chronic migraine symptoms.