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Migraine surgery is an outpatient procedure which addresses peripheral nerves through limited incisions. Depending on the symptoms of the patient and the screening results following nerve blocks or Botox, different areas of the head and neck may be addressed to treat the nerves found to be the migraine trigger in a given patient.
Local anesthetic is applied to the back of the neck and a Tuohy needle is advanced towards the location of the greater occipital nerve and lesser occipital nerve under fluoroscopic guidance. [8] [9] [10] When the location is confirmed, a temporary lead is placed through the needle before the needle is carefully removed.
Nerve decompressions are still a relatively new surgery, however a picture emerges from looking at the outcomes of some of the most studied nerve decompressions: carpal tunnel release, sciatic nerve decompression, and migraine surgery. Even within these commonly performed surgeries, the measurement of outcomes is not always standardized.
The objective of condylar decompression, also called jugular decompression and occipital release, is to balance the reciprocal tension membrane at the hypoglossal canal thus normalizing function of cranial nerve XII (hypoglossal nerve) function. [1]
Occipital nerve block is a procedure involving injection of steroids or anesthetics into regions of the greater occipital nerve and the lesser occipital nerve used to treat chronic headaches. [ 1 ] These nerves are located in the back of the head near in the suboccipital triangle along the line between the inion and the mastoid process .
Occipital neuralgia is caused by damage to the occipital nerves, which can arise from trauma (usually concussive or cervical), physical stress on the nerve, repetitive neck contraction, flexion or extension, and/or as a result of medical complications (such as osteochondroma, a benign bone tumour).
As cutaneous nerves cover all areas of the skin, and any surgery which requires incisions may inadvertently cause injury or scarring, now entrapping a cutaneous nerve. [15] A common tradeoff when electing to a neurectomy is that numbness along the nerve distribution is expected.
Occipital cryoneurolysis is a procedure used to treat nerve pain generated by peripheral nerves (nerves located outside of the spinal column and skull) commonly due to the condition occipital neuralgia. [1] A probe (no larger than a small needle) is carefully placed adjacent to the specific nerve.