Microsurgery For Migraines

MICROSURGERY FOR MIGRAINES
REPORT: MB #2882

BACKGROUND: Roughly 28 million people in the United States are victims of migraines and two-thirds of those who suffer from migraines are women. Migraines can be caused by a variety of factors. Hormonal changes, such as fluctuations in estrogen, appear to cause head pain. For some people, certain foods may also activate a migraine. Alcohol, aged cheeses, chocolate, aspartame and caffeine are some of the main culprits. In addition, stress, sensory stimuli like bright lights, and changes in the environment can trigger a migraine.  People often turn to pills for relief, but sometimes, the pain is only temporarily subsided. Now, a new microsurgery is providing an alternative, long-lasting treatment.

RELIEVING THE PRESSURE: Migraines are sometimes a result of the constriction of nerves located in the head. Most of the time the occipital nerve is affected, resulting in occipital neuralgia, which is characterized by a piercing or throbbing pain felt in the upper neck, back of the head and behind the ears. The occipital nerves run from the neck up through the back of the head to the scalp. Pressure may be put on the nerves from surrounding muscles and tissues or as a result of a trauma. The surgery decompresses the nerve by removing a small area of muscle that is surrounding and pinching it. The treatment works without compromising muscle function or by widening nerve tunnels. It takes about three months for patients to feel full relief. For those who still feel pain after the first surgery, a second surgery to remove the nerve completely is available. The surgery is safe, as only two out of every 400 patients get an infection. If a person suffers from a migraine every day or has to stop their daily routine because of migraines, he or she could be a candidate for surgery.

In order to be eligible for surgery, a person must have suffered from migraines for longer than six months. They must also be under the care of a neurologist or pain specialist, who has excluded any possible organic or metabolic causes of the conditioned and who has prescribed medical treatment regimens, such as medication. The person much also feel tenderness in the back, side, or front of their head. Patients can test whether or not the surgery will work by pressing on the tender nerves and later having a physician inject numbing medication into the hurt area. If the patient responds to the medication with positive results, the specific nerve that is agitating headaches can be determined. Ivan Ducic, M.D., chief of peripheral nerve surgery at the Georgetown University Hospital, has been performing the surgery for about four years and is one of two physicians currently carrying out the surgery on a regular basis. He believes that as time goes on, more and more physicians will rely on microsurgery in order to cure migraines. "It's very cool to help someone who had pain for 20, 30, or 40 years and have a relatively simple procedure to help them go on with life," Dr. Ducic told Ivanhoe. "It's very rewarding."

FOR MORE INFORMATION, PLEASE CONTACT:
Georgetown University Hospital, Division of Plastic Surgery
(202) 444-8751
http://www.georgetownuniversityhospital.org