Türk Nöroşirürji Dergisi 2019 , Vol 29 , Num 2
Surgical Approaches to Migraine
Atilla YILMAZ1
1Mustafa Kemal Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Hatay, Türkiye Migraine is one of the top 10 causes of disability in the world and recurrent headaches are often accompanied by nausea, vomiting, photophobia, and phonophobia. The prevalence of migraine in the community is around 12%.

Although its pathophysiology cannot be fully explained, it is reported that one third of the individuals with migraine disorders are resistant to medical treatment and 14% progress to chronic migraine disease. Despite the many medical treatment options currently developed, the lack of significant progress in the treatment of the disease has led to the development of various alternative invasive methods. The destructive invasive procedures formerly used such as neurolysis, neurectomy and posterior cervical rhizotomy, have been replaced by less destructive, recyclable and modulating interventions like Occipital Nerve Stimulation, Sphenopalatine Ganglion Stimulation and Supraorbital Nerve Stimulation because of the high risk and complications of the previous methods.

Many of the clinical trials on the effectiveness of neuromodulation in chronic migraine treatment have small patient groups and short follow-up periods, and the results obtained in some studies are somewhat far from what was hoped for. However, even the slightest improvement can be quite satisfactory in patients who are not responding to medical treatment. Neuromodulation interventions also have advantages such as a test period, stimulation adjustment, and a minimal invasive and reversible application. These advantages shows that neuromodulation applications will have an important future in many disorders. Although the results of clinical trials on chronic migraine treatment are quite different from each other, the results of large series and multicenter clinical trials will shed light on the treatment of these disorders. Anahtar Kelimeler : Migraine, Surgery, Neuromodulation, Occipital Nerve Stimulation, Sphenopalatine Ganglion Stimulation, Supraorbital Nerve Stimulation