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Last Updated: Dec 08, 2023
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Headache - When Do You Think A Surgery Is Needed?

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Dr. Sukalyan PurkayasthaNeurosurgeon • 29 Years Exp.MBBS, MD - Radiology, DNB (Radiology), DM (Diagnostic & Interventional Neuroradiology), CCST (UK)
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A headache is the most common ailment to affect men and women. Did you know that there are over 150 different types of headaches? Each of these different types of headaches has its own symptoms, triggers and needs to be treated in a different way. In some cases, you may even require surgery. This is often recommended for severe migraines and cluster headaches.

The different types of surgeries that may be performed to treat such headaches include:

  1. Neurostimulation: For this procedure, a wire electrode is inserted through the skin at the back of the neck near the occipital nerve and used to provide electrical stimulation. This form of surgery is best suited to patients who have benefited positively from an occipital nerve block.
  2. Radiofrequency thermocoagulation: This is one the most common forms of surgical treatment for cluster headaches. For this procedure, a radiofrequency current is used to heat tissue of a certain area. By doing this, the passage for pain is obstructed and headaches are relieved. Some of the side effects of this surgery could include corneal sensory loss, severe facial dysesthesias and reactions to anesthesia. In rare cases, it could also cause a stroke, infections or motor weakness. Thankfully, these effects typically are resolved within 6 months.
  3. Microvascular decompression: This is an invasive procedure that is performed while the patient is under general anesthesia. It also involves a craniectomy. The aim of this procedure is to remove a vascular loop that compresses a nerve and thereby restore normal anatomy. Hospitalization is typically required for a few days after the procedure
  4. Gamma knife radiosurgery: This is the type of neurosurgery where the trigeminal nerve is hit by radiation. This procedure can be performed as an outpatient procedure and can be completed in a few hours. It has a very low rate of complications but the long term effects of this form of treatment are not yet clear. There may also be a high rate of relapses associated with this form of treatment.
  5. Septoplasty: In the case of migraines, a deviated septum may be contributing to your headache. In such cases, surgical correction of the septum can help relieve pressure on the nerves that pass through it and in turn reduce the frequency and intensity of your headaches. Septoplasty addresses common issues concerning the septum such as a bent cartilage or deviated cartilage. This procedure can be performed under local or general anesthesia. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.
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