In-Depth Review of Symptoms, Triggers, and Surgical Deactivation of Frontal Migraine Headaches (Site I). Issue 3 (September 2016)

• Record Type: Journal Article
• Authors: Kurlander, David E.; Ascha, Mona; Sattar, Abdus; Guyuron, Bahman
• Is Part Of: Plastic and reconstructive surgery. Volume 138:Issue 3(2016:Sep.)
• Publication Date: 2016-09
• Subjects: Surgery, Plastic -- Periodicals; 617.95205
• DOI: 10.1097/PRS.0000000000002479
• Languages: English
• ISSNs: 0032-1052

Abstract

Abstract : Background: This study reports details of the technique and assesses efficacy of surgical deactivation of frontal migraine headaches. In addition, this study examines the effect of surgical deactivation of frontal migraine headaches on migraine triggers and associated symptoms besides the pain. Methods: Charts of 270 patients undergoing surgery performed by a single surgeon for frontal migraine headaches, who were followed for at least 1 year, were analyzed. Median regression adjusted for age, sex, and follow-up time was used to determine postoperative reduction in frontal-specific Migraine Headache Index, which is the product of duration, frequency, and severity. Reduction in migraine-days, which is the product of duration and frequency, was also measured. The association between individual symptom or trigger resolution and frontal-specific Migraine Headache Index reduction was studied by logistic regression. Details of the surgical treatment are discussed and complication rates are reported. Results: Eighty-six percent of patients reported a successful operation (≥50 percent improvement of frontal-specific Migraine Headache Index) at least 12 months after surgery (mean follow-up, 3 years). Eighty-four percent of patients had a successful operation as measured by migraine-days. Fifty-seven percent of patients reported complete elimination of frontal migraine headaches. Symptoms resolving with successful site I surgery beyond the headaches include visual aura and blurred or double vision ( p < 0.05). Triggers resolving with successful site I surgery include fatigue, weather change, and missed meals ( p < 0.05). Conclusions: Surgical deactivation of frontal migraine headaches provides long-lasting migraine relief. Successful site I surgery is associated with changes in specific symptoms and triggers. This information can assist in trigger avoidance and contribute to constellations used for frontal migraine headache trigger-site identification. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.