Nerve Decompression Surgery

Dr Doumit, a world-renowned plastic and craniofacial surgeon, offers surgical treatment of migraine headaches in  Montreal Migraine headaches affect an estimated 12% of the US population. Every year 28 million patients suffer from migraine headaches. Migraine headache is a major burden on patients: Collective loss of 112 million workdays, and $14 billion in productivity /per year. The cost of Medications is $ 1.5 billion. How is MIGRAINE HEADACHE diagnosed? Diagnosis of migraine headache is made by a neurologist. The International Headache Society published guidelines to help the neurologist make the diagnosis. A patient must have At least 5 headache attacks lasting 4 – 72 hours with at least two of the four following characteristics:1. Unilateral location, 2. Pulsating quality, 3. Moderate or severe intensity, 4. Aggravated by routine physical activity had the curative migraine surgery done by Dr. Doumit in May 2016. It has now been over 3 months, and my headaches have reduced by 80%. I am very satisfied with the result and the services of Dr. Gaby Doumit. D Plant

Causes

Foods: Aged cheeses, Chocolate, Caffeine, Processes Meat, Alcohol, Aspartame, Nuts, Smoked Fish, Avocados, Onions, tomatoes.

Medications: Antibiotics, Antihypertensives, HRT, SSRI, Vasodilators, Oral Contraceptives, Nitrates, Decongestants, Benzodiazepine

Environmental: Flashing lights, Bright lights, fluorescent lights, strong odors, weather changes, high altitudes, pollution, travel

Lifestyle: Emotional stress, sleep disturbances, overexertion, menstruation, menopause, caffeine withdrawal, fasting, oversleeping.

The exact cause of migraine headaches is still largely unknown.

There are many theories.

1- Central Nervous System Disorders – genetic predisposition, hyper-excitable brain (lower threshold for occipital cortex excitation)

2- Minor Vascular changes – oligemia begins in the occipital cortex, and spreads forward 2-3 mm/min. Aura phase: Spasm of Cerebral arteries; Headache Phase: vasodilation of cerebral arteries.

Treatment

Surgical treatment of migraine headaches consists of decompression of small nerves in the forehead and or back of the head.  Nerve decompression leads to a reduction of peripheral sensory neuron input (trigeminal nociceptive system). It leads to an indirect reduction in central sensitization.

The nerves and sites decompressed  in migraine surgery are:

Ideal Candidate

The best patient for surgical treatment of migraine headaches has the following characteristics:

1- Diagnosis of Migraine Headache (Made by a Neurologist)

2 – THE PATIENT CAN IDENTIFY THE SITES FROM WHICH THE HEADACHE ORIGINATE. IDEALLY ABLE TO PINPOINT THE ONSET OF LOCATION OF THE HEADACHE WITH A SINGLE FINGER.

Success Rate

Dr Guyuron et al published a key article on the success of migraine headaches. In his study, Dr. Guyuron found that 57% of patients who underwent surgical decompression obtained complete elimination of Migraine Headache vs 3.8% for the placebo (no treatment group).

In a recent publication, the authors reviewed all publications in the world. 8.3% – 63.2% of patients had complete elimination of pain after decompressive migraine surgery while 68% – 100% had improvements.

For RAMQ patients please see Dr Doumit at CHUM – Notre Dame Hospital.