Some severe headaches aren’t migraines.
They may be caused by a nerve being pinched instead.
When other treatments don’t work, surgery may offer relief.
Often called trigger site-induced headaches, pain from compressed nerves can last all day and be resistant to treatments like medication.
“Headaches that originate from compression of the occipital nerve will usually have a pain that starts on the back of the neck and radiates to the side of the head,” says Mayo Clinic microvascular plastic and reconstructive surgeon Dr Antonio Forte in the United States.
“Patients who have headaches that originate from compression of the supraorbital and supratrochlear nerve, they will usually start with a pain site that is above their eye, and that pain will radiate to their forehead.”
Nerves can be compressed by surrounding tissue or muscle.
Patients are usually evaluated by a multidisciplinary team that gathers the necessary data and imaging to develop a personalised care plan, which may include surgical nerve decompression.
Dr Forte, who has deep experience in migraine surgery, explains that occipital nerve decompression starts with a 5cm incision made along the hairline.
“We are able to then identify your greater occipital nerve and then remove the adjacent muscle and fascia that may be compressing the nerve,” he says.
“When patients undergo surgery for decompression of the supraorbital or supratrochlear nerve, we then perform an incision that is similar to the incision that we do when we are performing a cosmetic eyelid surgery.”
Surrounding tissue is removed to relieve pressure on the nerve.
Dr Forte says that many patients feel relief within weeks of nerve decompression surgery. – Mayo Clinic News Network/Tribune News Service
