Pathogenesis and surgical therapy of migraine attacks caused by weather (Foehn) and menstruation

This work reports for the first time on the pathological background and the successful definitive surgical treatment of migraine attacks caused by weather (Foehn) changes, menstruation, nutrition (cheese, chocolates, red wines etc), and psychophysical stress. Forty-two patients between the ages of 13 and 48, who were subdivided into an earlier and later treatment group, were surgically treated for migraines caused by the factors mentioned above. In the first group of 15 female patients that was treated, the surgical technique consisted of subperichondral septum correction crushing and partial or total resection of the middle concha and ethmoidal opening. In four of the patients where no septum deviation was observed, a resection of the middle nasal concha and a transnasal opening of the ethmoidal cells in the area of the middle nasal passage was performed. In the later group consisting of 27 patients, the surgical technique was simplified so that only subperichondral septum correction and crushing of the middle concha was performed, without total resection of the concha and ethmoidal cell opening. Up to the present all the 42 patients operated on have been free from migraine attacks, the first operation having been performed seven years ago and the last eight months ago.