There are almost 1.7 million traumatic brain injuries in the United States every year, and the most common complaint following these injuries is a headache. While many patients experience a spontaneous resolution of their post-traumatic headache in the months following their trauma, many others continue to suffer from a persistent and debilitating post-traumatic headache.

The most common type of post-traumatic headache resembles a migraine headache with similar symptoms and type of pain. The misdiagnosis of migraine headaches following trauma is unfortunately common, making it difficult to effectively treat the pain and other symptoms.

Patients with a headache immediately following any sort of trauma should be evaluated by a physician as soon as possible. Such headaches are especially likely to arise following an episode of head or neck trauma and can be an unrelenting reminder of a traumatic event.

These headaches can result from a variety of post-traumatic problems and different types of injuries, but they often follow a specific type of injury such as whiplash or other sudden movements. These injuries can cause inflammation or constriction of the nerves in the head, back of the neck or base of the skull. Luckily, these post-traumatic headaches can often be treated, and in many cases entirely alleviated, by surgical release of these nerves through migraine surgery.

Migraine Surgery for Post Traumatic Headaches

Migraine surgery is the surgical release of the nerves contributing to migraine headache symptoms. This short outpatient operation may be recommended for patients suffering from chronic trauma-related migraine headaches who cannot control their symptoms with non-surgical treatments and would prefer a long-term solution.

At Migraine Surgery Specialty Center in Santa Barbara, board-certified plastic surgeon Dr. Lowenstein can quickly determine if a patient suffering from post-traumatic headaches is a candidate for migraine surgery using a diagnostic nerve block. This technique can confirm if migraine surgery will provide long-term pain relief. Most people with post-traumatic headaches are good candidates for migraine surgery.

How Does Migraine Surgery for Post-traumatic Headaches Work?

Migraine surgery, also called nerve decompression surgery, is a procedure in which certain nerves are released from the tension of the surrounding muscle tissue. Migraine surgery is a quick outpatient procedure with a greater than 90% success rate in providing long-term improvement from chronic pain and other symptoms associated with post-traumatic headaches.

The details of migraine surgery are described at length here. During the procedure, small, well-hidden incisions are used to access the regions of concern identified using the diagnostic nerve block. The nerves are then released from the surrounding tissue causing pressure.

The nerves are often padded with a piece of adjacent fat to avoid further compression, and the new relaxed position of the nerve is without irritation from the surrounding muscles. Once the compression is released, the nerve returns to its normal state and no longer sends distress signals to the brain. Without the distress signals, headache pain cannot be triggered, and post-traumatic headaches subside.


Do post-traumatic headaches happen immediately?

Migraines caused by trauma often begin shortly or immediately after the initial injury, though this is not always the case.

What causes post-traumatic headaches?

These headaches have a variety of possible causes, some that are only temporary, and some that can be chronic. Head pain immediately after an injury needs to be evaluated to rule out intracranial bleeding (bleeding in or near the brain). This is usually done with CT or MRI scans in the emergency room.

Once these urgent problems are ruled out, long-term migraines can come from tightening muscles in the head and neck that can eventually turn into tight scar tissue. This pain can also come from a sudden stretching of the nerve itself that results in chronic inflammation and migraine headaches, and this is most often the case in patients with a whiplash-type of injury.

Do patients always have an injury in their past?

Post-traumatic headaches can result from even the most minor whiplash injuries, and often a migraine surgery patient will not correlate their headaches with a specific injury. In many cases, after a long discussion and medical evaluation, patients will remember that they did have some type of head or neck injury around the time their migraines began.

What makes migraine surgery helpful in post-traumatic headaches?

After ruling out the emergent causes of headaches, muscle tightness, tissue scarring and chronic nerve inflammation can often be released surgically, allowing the nerve to relax. By releasing the nerve from the surrounding tissue, inflammation can be reduced, as can impingement and constriction of the nerve from any surrounding tight muscle or scarring.

Is migraine surgery permanent?

Migraine surgery is permanent. Around 90% of all patients who undergo migraine surgery experience long-term improvement, if not complete alleviation, of their pain following their procedure.

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