Refractory Migraine Surgery

At The University of Kansas Health System in Kansas City, we offer minimally invasive migraine surgery for refractory migraines. Advanced treatment options are often necessary for this type of migraine because it does not respond to medications and other therapies. It may also be an option for those who have migraines that do respond to treatment, such as Botox, but only for a short time. Surgery may be preferred over the costs and side effects related to repeated therapies.

Migraine surgery is a procedure that targets specific trigger points suspected to cause migraine headaches. The trigger points correspond to nerves which are compressed by normal variations of facial anatomy. The goal of surgery is to reduce or eliminate headache frequency, intensity and duration.

During the procedure, your trigger points are identified, and nerves are decompressed by releasing or removing areas of compression, such as muscles, vessels or fascial bands. A small incision is made near each affected trigger point (forehead, temple, nose and neck). The surgeon then examines the nerve and any muscle, vessel, fascia or bony passages that are compressing the nerve and causing pain. Once all points of compression are relieved, the incision is closed in layers.

The risks of migraine surgery include:

• Bleeding
• Contour deformities
• Deep vein thrombosis (DVT), which occurs when a blood clot forms in a vein
• Facial asymmetry
• Infection
• Permanent numbness or changes in skin sensation
• Persistent headaches
• Pulmonary embolism (PE), a blockage in one of the pulmonary arteries in your lungs
• Risks associated with anesthesia

After surgery, you may have swelling or discomfort. You will be sent home with a short course of pain medication to take during the first few days after surgery. After 1 week, most people do not require medication.

The overall cost of migraine surgery varies, with an average total cost between $5,000-$15,000. This includes facility, surgeon and anesthesia fees, as well as other associated costs. Depending on your health insurance, the surgery may be partially or fully covered.

Learn more about plastic surgery at The University of Kansas Health System.