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Cluster Headache Help and Support >> Medications,  Treatments,  Therapies >> Surgery?
http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl?num=1233154913

Message started by Kim Dyer on Jan 28th, 2009 at 10:01am

Title: Surgery?
Post by Kim Dyer on Jan 28th, 2009 at 10:01am
"Different types of surgery have been used over the years to treat chronic cluster headaches, but those which deaden the pain-sensitive cells of the fifth cranial nerve have worked best. Use of radiofrequency heating by means of a needle that deadens the trigeminal root nerve fibers may be effective, with fewer side effects than other invasive procedures. However, this therapy is usually used only after all other treatment has failed."

I found this artice on a local news site. Has anyone ever suggest this to their doctor or had this procedure?

Title: Re: Surgery?
Post by Bob_Johnson on Jan 28th, 2009 at 11:13am
I did a search on PubMed [major source of medical info] and found only one article in the last several years. Of the 12 abstracts hit, most were dated in the 1990s. This suggests to me that it's an approach which has not gained much attention.

But this is the latest abstract:

Headache. 2008 Sep 9. [Epub ahead of print]
Sphenopalatine Ganglion Radiofrequency Ablation for the Management of Chronic Cluster Headache.

Narouze S, Kapural L, Casanova J, Mekhail N.

Cleveland Clinic Foundation-Pain Management Department, Cleveland, OH, USA.

Objectives.- Chronic cluster headache patients are often resistant to pharmacological management. Percutaneous radiofrequency ablation (RFA) of the sphenopalatine ganglion (SPG) was shown before to improve episodic cluster headache but not chronic cluster headache. We were interested to examine the effect of such intervention in patients with intractable chronic cluster headache who failed pharmacological management. Methods.- Fifteen patients with chronic cluster headache, who experienced temporary pain relief following SPG block, underwent percutaneous RFA via the infrazygomatic approach under fluoroscopic guidance. Collected data include demographic variables, onset and duration of the headache, mean attack intensity (MAI), mean attack frequency (MAF), and pain disability index (PDI) before and up to 18 months after procedure. Results.- At 1-, 3-, 6-, 12-, 18-month follow-up, the MAI was 2.6, 3.2, 3.2, 3.4, 4.2, respectively (P < .0001, P < .0001, P < .0001, P < .0005, P < .003, respectively). The PDI improved from 55 (baseline) to 17.2 and 25.6 at 6 and 12 months respectively (P < .001). The MAF improved from 17 attacks/week to 5.4, 6.4, 7.8, 8.6, 8.3 at 1-, 3-, 6-, 12-, 18-month follow-up visits (P < .0001, P < .0001, P < .0001, P < .002, P < .004, respectively).
Conclusion.- Our data showed that percutaneous RFA of the SPG is an effective modality of treatment for patients with intractable chronic cluster headaches. Precise needle placement with the use of real-time fluoroscopy and electrical stimulation prior to attempting radiofrequency lesioning may reduce the incidence of adverse events.

PMID: 18783451 [PubMed

Title: Re: Surgery?
Post by ClusterChuck on Jan 28th, 2009 at 1:03pm
Surgery is only for those that have tried everything else, and mostly chronic.  You have a LONG way to go, before resorting to such a step.  There are plenty of medications and combinations for you to try.  AND you are episodic, not chronic.

You can make it, girl!  Get on a preventative, that works for you (this may take time), and get an abortive that works too, for those hits that make it through the preventative medication.

Oxygen is the safest, cheapest, and most successful of all abortives.  See the button, on the left side of your screen, titled oxygen info.  That should answer most of your questions.  If not, don't be afraid to ask.

Good LUCK!

Chuck

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