[Surgical treatment of migrainous neuralgia]

The paper gives the results of surgical management in 18 patients with migrainous neuralgia who underwent 20 surgical interventions. High-frequency transcutaneous trigeminal rhizotomy eliminated pain in 2 of 6 patients. Microsurgical radicular exploration of the trigeminal nerve (1 case) and the intermediate facial nerve (2 cases) revealed no vascular compression of nerve fibers. Vertical ultrasonic destructions of the trigeminal caudal subnucleus and the descending upper spinal segment CII tract in 12 patients. The upper border of nucleotractomy varied from the obex level of the fourth ventricle to as long as 5 mm below. Complete removal of migrainous neuralgia was achieved in 11 patients followed for 12-81 months and in 1 patient with recurrent facial pain successfully treated with repeated trigeminal nucleotractotomy. Sensory sequelae of destruction and somatotopic organization of the trigeminal caudal subnucleus are also dealt with in the paper.