Migraine Surgery

Part of the evaluation that helps determine success involves the identification of peripheral migraine trigger zones that are responsible for the triggering of some, if not all of your migraine headaches. Peripheral triggers involve irritation, compression, vibratory stimulation, or simply errant signal interpretation through primarily branches of the trigeminal nerve (cranial nerve #5) and or the greater occipital nerve.

Nerve decompression is a migraine surgery that involves the decompression of several of the small terminal branches of the trigeminal and of the occipital nerves. When intranasal vibratory stimulation through the trigeminal nerve is felt to be a trigger, elimination of the vibration through opening of the nasal airway is performed.

Generally, the surgery for migraines will be done as an outpatient procedure under sedation or general anesthesia. Patients with signs of localized nerve pain are the most likely to be offered surgery, while Botox testing or treatment may be the best first option for those with more globalized headaches.

Often the surgery involves decompressing the affected nerves by removal of muscle and sometimes vessels or even bone that is pressing on the nerves. The nerves are often covered with fatty (non-contracting) tissue.

When performed on the brow, the surgery is similar to a cosmetic brow lift.

In back of the neck, the greater occipital nerve is treated similarly through a hidden incision in the scalp.

Nasal airway surgery is a variation of the commonly performed procedure for a deviated septum resulting in breathing difficulty. Incisions are small and hidden.

The surgical procedure time can vary depending on the number of trigger sites (1 to 5, but usually 2-3). Each zone or trigger site procedure can take between 15 minutes and 2 hours.

The success rate for the treatment is 90%, with at least a 50% reduction of migraine symptoms. Approximately 35% of patients no longer experience headaches.

Dr. Branch's first patient has gone from chronic daily headaches to ONE headache over the span of 9 years since the day of her surgery.

How long does the surgery last?

Research has shown headache improvement/elimination to last at least 5 years. Dr. Branch's first patient has had 15 years of complete relief since her surgery in 2003.

Despite the sound of "migraine surgery", it is not brain or spine surgery. It is a field that focuses on shallow anatomy and sensory nerves, or employs familiar minimally invasive surgical techniques in the nasal airway. All surgery is serious and carries risk, but after over 1600 litigation-free migraine surgeries, complaints are rare and side effects usually involve some form of numbness or improvement in nasal breathing. The following is a list of possible side effects - Mild bruising or swelling lasting a few days up to 14 days, usually, Temporary (and rarely permanent) numbness in the forehead and scalp, Intense itching as sensation returns and nerves recover from surgery, Change in brow appearance and movement, Change in nasal breathing, usually improved, Migration of pain to a new or existing area. Talk to your doctor or physician for more information