MIGRAINE SURGERY

For patients suffering from chronic, debilitating migraines that have not responded to conventional treatments, migraine surgery may offer significant and lasting relief. Ideal candidates are those with clearly identified trigger points—often located in the forehead, temples, back of the head, or around the eyes—and who have had a positive response to diagnostic tests such as Botox injections or local anesthetic nerve blocks, which help confirm the source of their pain.

During surgery, small decompression procedures are performed to relieve pressure on the sensory nerves believed to trigger migraine attacks. There has been ample literature showing success (defined as more than 50% reduction in migraine headache frequency, severity, or duration) of surgical treatment of migraine for carefully selected patients. With proper evaluation and surgical planning, migraine surgery can significantly improve quality of life for select patients who suffer from intractable migraine headaches.

A Targeted Approach for Chronic Headache Relief

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Published studies have shown various success rates ranging from 50-100%, with surgical “success” defined as more than 50% improvement in migraine headache severity, frequency, or duration. Results vary depending on trigger site location, individual anatomy and accurate identification of such trigger points.

How successful is migraine surgery?

Frontal migraines: Decompression of the supraorbital and supratrochlear nerves (forehead).
Temporal migraines: Targeting the zygomaticotemporal or auriculotemporal nerve
Occipital migraines: Greater and lesser occipital nerve decompression at the back of the head.

What are the common trigger points treated?

We typically use Botox or local anesthetic nerve blocks to temporarily deactivate potential trigger points. If your migraine symptoms improve in the days or weeks following, this suggests you may benefit from surgical decompression in that area.

How are trigger points identified before surgery?

The best candidates are patients who:

Suffer from chronic migraines not adequately controlled by prescribed medication.
Have specific trigger zones that can be localized. (Can you point to a spot where the headache starts?)
Show improvement with Botox injections or local anesthetic blocks in those areas.

We perform a thorough evaluation, including review of medical history and any response to prior treatments, to determine if surgery is a good fit.

Who is a good candidate for migraine surgery?

Migraine surgery involves relieving pressure on specific sensory nerves that are thought to trigger migraine headaches. These “trigger points” are often compressed by muscles, blood vessels, or other soft tissue structures. By surgically decompressing or removing these sources of pressure, we can reduce or eliminate migraine attacks for appropriately selected patients.

What is migraine surgery, and how does it work?

It’s possible to treat multiple trigger zones in one operation or stage them over time, depending on your symptoms and surgical plan. Sometimes, patients may notice a new trigger site that was masked prior to surgical treatment, which may require further assessment and treatment. A personalized evaluation is key.

What if I have multiple trigger points?

In some cases, insurance may cover parts of the diagnostic process, but migraine surgery is often considered elective and not universally reimbursed. We’re happy to provide documentation for patients seeking preauthorization or reimbursement.

Is migraine surgery covered by insurance?

Most patients go home the same day. Downtime is usually 1–2 weeks depending on the area treated. Mild swelling, bruising, and numbness near incision sites is common but temporary. Many patients begin to notice migraine improvement within the first month after surgery.

What is the recovery like?

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