Behind the Headache: Cutting-Edge Surgical Interventions for Migraines- Nerve Blocks, Stimulation, and More

Abstract

Surgical techniques for managing chronic migraines are gaining traction, especially for patients who do not respond to conventional pharmacological treatments. These procedures target specific neural structures involved in migraine pathophysiology. Nerve blocks, particularly occipital nerve blocks, are commonly used to provide short-term relief by injecting local anesthetics or corticosteroids around pain-transmitting nerves. Decompression surgery focuses on relieving pressure on neural structures, including the occipital and trigeminal nerves, by removing or altering surrounding tissues. This method has demonstrated a significant reduction in the frequency and intensity of migraines. Another technique, nerve resection/ablation, involves surgically removing or destroying nerves that are thought to contribute to migraine attacks, offering a more permanent solution in some cases. Additionally, deep brain stimulation (DBS) has emerged as an option for patients with refractory migraines. DBS involves implanting electrodes into specific brain regions to modulate pain pathways, leading to significant improvements in migraine frequency and intensity. These techniques show promise in providing relief for patients with chronic and treatment-resistant migraines, though careful patient selection and post-operative monitoring remain crucial for success.