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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.
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.
In March 2011, investigators from Australia and several other countries published the results of the DECRA [5] trial in The New England Journal of Medicine.This was a randomized trial comparing decompressive craniectomy to best medical therapy run between 2002 and 2010 to assess the optimal management of patients with medically refractory ICP following diffuse non-penetrating head injury.
A migraine headache can throw your whole day off track. But if you can learn to pick up on your subtle migraine warning signs, you might able to avoid the pain entirely , experts say.
The aim of decompression surgery is to open the affected area and nerve sheath, and to release pressure. This reduces compression on the nerve fibers, improves blood circulation and minimizes damage to distal nerve fibers.
The problem is difficult to address, and revision surgery is less successful than primary carpal tunnel release surgery. [43] Injury to the median nerve proper occurs in 0.06% of cases. [44] Risk of nerve injury has been found to be higher in patients undergoing endoscopic CTR compared with open, though most are temporary neurapraxias. [45]
Less often the nerve is thin and pale. Once the vessel is mobilized a sponge like material is placed between the nerve and the offending blood vessel to prevent the vessel from returning to its native position. After the decompression is complete, the wound is flushed clean with saline solution. The dura is closed in a watertight fashion.
Neurectomy can be an alternative to a nerve decompression for nerve entrapment, such as when the nerves have no motor function and numbness along the dermatome is acceptable. A neurectomy is not a mutually exclusive option to a decompression as a neurectomy can also be used after a failed decompression. [1]