Edward P. Miranda, M.D

San Francisco, CA

A Medical Corporation

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   Board Certified by the American Board of Plastic Surgery
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Migraine Surgery: Information for Health Care Professionals

Incidence of Migraine Headaches

  • 8-12% of the U.S. population
  • 112 million workdays lost.
  • $14 Billion lost productivity

Migraine Headache Surgery Effectively Eliminates or Reduces Migraine Headaches

  • Randomized double-blinded placebo (sham surgery) controlled clinical trial demonstrated surgical efficacy.
  • 84% experienced at least a 50% reduction in migraine
  • 57% experienced complete elimination of migraine headaches at 1 year after surgery.
  • Surgery was effective in all trigger points tested:
    • Frontal
    • Temporal
    • Occipital

Who is a candidate?

  • Migraine headache diagnosed by a neurologist or pain specialist, and
  • Not adequately treated by existing medications, or
  • Migraine medications cause undesirable side-effects, or
  • Frequency or severity of migraine headaches (even with effective medication) intereferes with daily life, and
  • A trigger point is identifiable (e.g. frontal, temporal, occipital, nasal).

How Is Migraine Surgery Performed?

  • Outpatient procedure (in most cases).
  • The triggering nerve is decompressed (trigeminal, supra-orbital, supra-trochlear, and/or greater occipital) or divided (zygomatico-temporal).
  • Decompression is conceptually similar to carpal tunnel surgery.
  • Migraine Surgery can be minimally invasive:
  • Can be done endoscopically for the supra-orbital, supra-trochlear and zygomatico-temporal.
  • Can be performed endo-nasally for naso-septal trigger points.
  • Migraine Operations are similar in approach to endoscopic brow lift and/or septoplasty.
  • Open decompression via small access incisions hidden at the hairline for the occipital trigger point.
  • Recovery is often 1-2 weeks with some improvement seen quickly in many cases.

Current Treatment Strategies Are Often Inadequate

  • Triptans (e.g. sumatriptan, Imitrex) are often effective.
  • Problems with triptans include delay (pain) from time of administration to time of medication effect.
  • Side Effects:
    • Drowsiness
    • Weight Gain
    • Hair Loss
  • Contraindicated in:
    • Pregnancy
    • Coronary Artery Disease
    • History of Stroke

FOR MORE INFORMATION:

77 Van Ness Ave, Suite 302
San Francisco, CA 94102
(415) 379-9015

Info@PacificMigraine.com

Certified by the American Board of Plastic Surgery