Sleepless young woman suffering from insomnia or nightmares close up, bad dreams, tired depressed female covering eyes with hands, lying on pillow in bed, feeling headache or migraine
Sleepless young woman suffering from insomnia or nightmares close up, bad dreams, tired depressed female covering eyes with hands, lying on pillow in bed, feeling headache or migraine

Migraine Awareness Month Q&A with Dr. Ryan D. Endress

June 1, 2021

Q: What is migraine/severe headache surgery?

Migraine/severe headache surgery is a minimally-invasive procedure that aims to reduce or eliminate migraine headache frequency, intensity, and duration by releasing or removing the muscles, vessels, or connective tissue compressing the involved nerves.

Q: Who is a candidate for migraine/severe headache surgery?

You are a candidate if:

  • You have been diagnosed with migraine or chronic headaches by a neurologist or headache specialist.
  • You have tried several therapies without success.
  • Your migraine headaches typically originate from the same locations (trigger point).
  • Your migraines improve after receiving an injection to the trigger point (Botox, local anesthetic).

Q: What is the treatment process like?

On the day of the surgery, you will be sedated with an IV and general anesthesia before an incision is made based on the trigger location (frontal – eyelid crease, temporal – hairline, occipital – back of the neck within the hair, rhinogenic – inside nostrils). Any muscle, vessel, connective tissue, or bony passage compressing the nerve is then removed, relieving the trigger location.

It is typical for patients to go home the same day as surgery, usually with Jackson-Pratt drains in place. The drains are removed two to four days following surgery, depending on output.

Q: What can I expect after the surgery?

It is extremely rare for the surgery to not help alleviate symptoms. A surgery is considered successful when patients report at least a 50% reduction in migraine/severe headaches and symptoms. Studies have demonstrated a success rate of between 83%-92%, depending on the type of condition and the nature of the surgery. The results can be immediate or take several weeks or months to observe. Certain surgeries can delay these results.

If the migraines do not seem to improve, this commonly is the result of a trigger site that was not initially identified. It is always possible to have surgery on other trigger sites that were not detected earlier.