Migraines, which can cause excruciating pain and dizziness, affect 40 million Americans, or 13% of the population. That includes the author. It all began around three and a half years ago. It wasn’t until she started having headaches that she noticed a gentle throbbing sensation in the back of her skull, which most people equate with the need to extend or twist their neck. It was only a matter of time before she realized that the pulsating sensation was actually a strong, radiating ache that travelled from the base of her skull to her right eye. A full day’s worth of trauma would be in store for her.

An effective pharmaceutical was discovered by a neurologist after several months of trial and error with various medications. However, there was a negative side effect — notably, a fog in the head. While her migraines had improved significantly, her brain fog was unbearable. She had trouble remembering names and passwords; she couldn’t finish a movie in one sitting, and she got lost while going around her neighbourhood. Her physician reassured her that this was quite normal and advised her not to be alarmed. Her husband, on the other hand, pushed her to look for a long-term solution.

Inquiring about further therapeutic choices, her neurologist informed her that all options had been exhausted. After then, there was nothing more to do. Listening to the news was both annoying and upsetting. Then, just a few weeks later, she attended a presentation on occipital nerve decompression surgery by Stanford Medicine plastic and reconstructive surgeon Catherine Curtin, MD.

She had no idea that this would be her first exposure to the operation that had healed her of her migraines in the literal sense. To learn more about the operation and what it may accomplish for those with migraines, she recently spoke with Curtin.

In what ways does occipital nerve decompression differ from other types of surgery?

A method called occipital nerve decompression surgery can be used to treat some types of headaches. During the procedure, a small incision is made in the back of your skull and the nerve is freed from any surrounding tissue that is compressing it and causing it discomfort.

What is the success rate of the operation? What are the dangers?

Most patients get better, but they still suffer from occasional headaches. It’s wonderful for roughly 20% of folks. And it doesn’t function at all for another 20% of people.

There are dangers associated with every type of surgery. These include the possibility of bleeding, infection, or permanent scars. They’re extremely uncommon. Surgery may fail to relieve your discomfort to your satisfaction.

Why aren’t more doctors and patients aware of this procedure?

Bahman Guyuron, MD, is a plastic surgeon in Ohio who pioneered the use of nerve decompression surgery to treat migraines. When he performed facelifts or Botox treatments on patients, he discovered that some patients reported that their migraines had substantially improved. He began to investigate this phenomenon and discovered that extreme headache pain was caused by squeezed nerves.

For his research, he conducted an experiment in which some patients got the entire nerve decompression surgery, while others did not. Because there is a placebo effect, both groups of patients benefited, but the decompression patients fared better and the improvements lasted longer.

Many neurologists were dubious about the efficacy of surgery for the treatment of migraines until recently. A more fundamental issue such as aberrant blood flow or nerve activity in the brain is thought to be the cause of migraines, according to this theory. Because of Guyuron’s focus on aesthetic surgery, his research was criticized. This procedure was strongly opposed by a group of neurologists. Occipital nerve decompression is still not covered by some insurance companies, even today.

Can anyone with migraines benefit from this procedure?

For the vast majority of patients with migraines, surgery isn’t necessary. Identifying those whose pain is being exacerbated by nerve compression is the difficult part.

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