Migraine headache surgery can be a life-changing experience. Over 90% of patients who undergo surgery for their migraine headaches experience significant improvement in the frequency and symptoms of their headaches, while approximately 40% of patients experience a complete resolution of their migraine headaches following migraine surgery.

About half of the patients who have nerve decompression surgery for migraines and occipital neuralgia find that although they still do sometimes get headaches, they happen less than half as frequently as they did before surgery. More importantly, the pain is nowhere near as bad as it used to be, and most often can be treated with over-the-counter medications like Tylenol.

Who Is the Ideal Candidate for Migraine Surgery?

Here are some characteristics that might make you a good candidate for migraine surgery:

  • You have been diagnosed with migraines, tension headaches, post-traumatic headaches, or chronic headaches by a neurologist
  • You have tried several different therapies, such as behavioral changes and medication, without success
  • You are otherwise physically healthy

When deciding if this surgery is right for you, Dr. Lowenstein will perform a short-term nerve block of the nerves suspected to be causing the pain. If this block temporarily relieves the pain, this indicates the correct nerve or nerves to target and is a sign that migraine surgery will succeed.

Dr. Lowenstein will help you determine if you are a good candidate for migraine surgery during your consultation. Call us today at 805-969-9004 to schedule a consultation to see if migraine surgery could be right for you.

Migraine Surgery Overview

At Migraine Surgery Specialty Center, migraine surgery is performed in our specialized private facility in Santa Barbara and does not require an overnight stay. It’s important to note that nerve decompression surgeries are not brain surgeries. They are significantly less invasive and time-consuming. Most of our patients are up and about the day after their surgery. In a week or two, they can return to their normal activities.

Preparations are the same as with any surgery. You will stop taking anti-inflammatory medications, blood thinners, aspirin and most supplements for a week prior to your migraine surgery. You will also need to arrange for someone to drive you to and from our offices.

After being brought to our state-of-the-art operating room for your headache surgery, you will be gently put to sleep by our anesthesia staff. During your headache surgery, Dr. Lowenstein will use special instruments to isolate and free the nerves from surrounding tissue. These tissues will be released so that the nerve in question can lie comfortably in a manner that is not constricting or susceptible to irritation.

Post Migraine Surgery

After your migraine surgery, you will be awakened from general anesthesia. Our recovery room at our migraine headache center is a private, comfortable room in which you can wake up gently without bright lights or loud noises, with personalized nursing to aid in the initial stages of your recovery.

Sutures may or may not need to be removed the following week, depending on the region of the head and neck that has been operated on. Some patients who undergo nerve decompression migraine surgery have “unmasking” of pain in other areas. This means that if the majority of your pain is coming from the occipital nerves, and a lesser pain is coming from the supra-orbital nerve, you may not notice the supra-orbital pain because of the severity of the pain caused by the occipital nerve issues.

Surgery to decompress the occipital nerves may be entirely successful, relieving all pain from the neck and back of your head, but this might make you aware of your supra-orbital pain now that the main source of discomfort is gone.

Many patients who have unmasked pain from secondary nerves are candidates for decompression from that new source and can achieve complete pain resolution. For most patients, the “unmasked” pain is so much less severe than the pain alleviated with the migraine surgery that they don’t feel compelled to have another operation.

Migraine Surgery Risks

There are risks and potential complications associated with any surgery. However, they are rare with nerve decompression migraine surgery. Though headache surgery has a 90% success rate, one out of 10 patients may not experience an improvement following their surgery.

Scarring from migraine headache surgery is usually minimal, and incisions are strategically placed in well-camouflaged regions. The most notable risk of migraine surgery, although it is rare, is that some patients experience numbness or itching of the forehead or scalp.

In rare instances when nerve damage is severe, the sensory nerves may need to be cut to provide pain relief. In most of these cases, the numbness that results is not concerning to the patient and often felt to be a small price to pay for the relief of their headache pain. In very few of these already rare cases, there may be an uncomfortable sensation in the area. Very rarely, a cut nerve can form a neuroma, or nerve scar tissue that can be painful and require reoperation.

During migraine surgery, the surgeon must discern a difference between sensory nerves and motor nerves. In the performance of migraine surgery, Dr. Lowenstein uses meticulous techniques to avoid vital motor nerves. Special tools familiar to nerve surgeons like Dr. Lowenstein are used to tell the difference between sensory and motor nerves. Because of this, paralysis of any kind is not a risk associated with migraine surgery.


What Steps Should I Take After Migraine Surgery to Avoid Side Effects?

There are limited recovery issues after migraine surgery. The main thing you can do to help the treated nerves calm down and reduce any swelling is to minimize blood pressure elevation in your head. Keeping excess pressure from building across your face and head helps prevent flares of headache pain. Try not to lift anything overly heavy for a couple of weeks or to bend down towards your feet. Sleep with your head elevated, and take it slowly when returning to strenuous exercise.

How Long Can I Expect My Results to Last From Migraine Surgery?

Over 90% of Dr. Lowenstein’s patients get significant or complete relief from migraine pain after migraine surgery. In most patients, the results are expected to be permanent.

How Long Does Migraine Surgery Take?

The length of your procedure depends upon the number of nerves Dr. Lowenstein needs to address. Migraine surgery can take anywhere from one to three hours.

What Kind of Anesthesia is Used for Migraine Surgery?

Dr. Lowenstein usually opts for general anesthesia for these procedures to maximize patient comfort during the operation. In some cases, local anesthesia can be used when only small isolated nerves are causing the headache pain.

What Is the Difference Between Migraine Surgery and Nerve Ablation?

Nerve ablation involves damaging the nerves so they temporarily cannot send their distress signal to the brain. This is often performed by pain doctors or neurologists using imprecise needles and radiofrequency to create a point of nerve damage which temporarily shuts the nerve down. As these nerves recover, they return to their irritated state and in fact, are often even more irritated from the damage that the ablation has caused. Nerve ablation is usually a temporary treatment that can cause more damage and pain if repeated several times. The goal of migraine surgery is to PREVENT nerve damage by releasing the nerve from the surrounding tissues that are causing irritation. Migraine surgery usually does not need to be repeated as it serves to return the nerve to a non-irritated, undamaged state, and therefore the distress signals that a damaged or compressed nerve creates are prevented from being created in the first place.

What Is the Difference Between Migraine Surgery and a Nerve Stimulator?

Nerve stimulators are small electronic devices that can treat many different types of pain, including migraines. Electric impulses from these devices are given to affected nerves to prevent them from communicating to the brain. While stimulators sometimes work, their placement involves guesswork as to the precise location. Nerve stimulators are controversial in that many pain doctors recommend them, while many others condemn them. Nerve stimulators are often complicated by malposition, lead breakage, and battery or generator failure. Many patients who undergo migraine surgery have tried nerve stimulators already without success.

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