Migraine surgery found effective among teens

Migraine surgery is effective among selected adolescent patients that don't respond to standard treatment, a recent study shows. Scientists report good outcomes in an initial experience with migraine surgery in younger patients. Migraine headaches are a common issue among children and adolescents, and have a significant impact on mental and physical health for patients and their families.

"Our data demonstrate that surgery for refractory migraine headaches in the adolescent population may improve and potentially completely ameliorate symptoms for some," said Bahman Guyuron, emeritus professor of plastic surgery at Case School of Medicine, Cleveland, Ohio.

Guyuron developed the migraine surgery techniques after noticing that some migraine patients had reduced headache activity after undergoing cosmetic forehead lift procedures going back to year 2000. The surgery targets "trigger sites" in the nerve branches that produce headaches.

Such trigger sites are detected using a constellation of symptoms, nerve blocks, ultrasound Doppler and CT scans. For the study, the team observed 14 teen patients, 11 females and three males, average age 16 years. All of them had debilitating migraine attacks that continued despite recommended medications.

Average headache frequency decreased from 25 per month before surgery to five per month afterward. "This represents a large group of adolescent migraine patients with continued symptoms in spite of specialized medical treatment," Guyuron noted. Although the experience is small and preliminary, the results suggest that migraine surgery, like in adults, is safe and effective in teenaged patients.

"Identifying the adolescent patient who would benefit from surgery is the most important aspect of surgical intervention," Guyuron and colleagues concluded.

(The study was outlined in the journal Plastic and Reconstructive Surgery)