Surgical technique 1: frontal decompression

At Global Medical Institute, Drs. Pietramaggiori and Scherer specialize in microsurgical decompression of peripheral nerves and vessels in the forehead to relieve your chronic frontal migraines, chronic frontal headaches and migraines refractory to conventional treatment in the forehead area.

Who should undergo migraine surgery such as frontal decompression? Who are the "good candidates"? How is this technique minimally invasive? How can you identify your chronic frontal migraine? How does the procedure work? What happens afterwards?

In this article, we invite you to find out more about the surgical technique performed by Drs Pietramaggiori and Scherer.

Who should undergo migraine surgery such as frontal decompression?

Migraine surgery is intended for migraine sufferers whose pain cannot be relieved with medication. The success of surgical treatment is intimately linked to the patient evaluation process, which is why good patient selection is key.

How to determine the right candidate for frontal decompression

As you will have gathered, the right candidate is the patient whose medication is not sufficient to manage the seizures. But it's also the patient who has already been under the care of a migraine specialist, such as a neurologist or family doctor, and who, after trying numerous migraine drug treatments, has continued to experience migraine attacks that are not easily manageable.

To identify the “right candidate” for frontal decompression surgery, we subject you to a detailed anamnesis (your medical history) and an evaluation phase lasting an average of three months, with diagnostic tests and a specific clinical examination. This will enable us to determine whether your migraine is indeed linked to compression of one or more nerves, and to target them precisely. If you have a migraine during this consultation, our migraine surgeons will perform local anesthesia in the painful area of the head. Sometimes, the right candidate can be identified quite quickly, especially if your pain disappears during the test phase.

Minimally invasive surgical techniques for your frontal migraine

Surgical techniques to relieve chronic frontal headaches or migraines at Global Medical Institute are minimally-invasive and can be performed under local anesthetic, general anesthetic or sedation (a form of light anesthetic where a product is injected through your veins, without intubation). The surgical techniques practiced by Drs Pietramaggiori and Scherer do not cut, burn or destroy any nerve branches in the head: the sensory frontal nerves responsible for your pain during frontal migraine attacks, or chronic frontal headaches, are decompressed or released.

How to detect your chronic migraine or frontal headache?

If, during an attack, your pain starts at a point in the inner corner of the eye, in the central part of the eyebrow, and radiates to the forehead and temples, then you probably suffer from chronic frontal migraine or headache.

Tests will be performed prior to surgery to confirm the diagnosis of your chronic frontal migraine or frontal headache. These tests may include Botox (botulinum toxin infiltration). Botulinum toxin infiltration for frontal headaches is also a treatment that can improve or eliminate your pain for several months (2-3 months on average). Botulinum toxin infiltrations can be repeated several times, and for several years. Minimally invasive surgery to treat frontal headaches aims to permanently reduce your pain.

How is frontal decompression performed?

Minimally invasive surgery to relieve frontal headaches, supraorbital migraines, vascular facial algias or chronic migraines refractory to conventional treatments at the frontal start is performed through a small, invisible incision in the upper eyelid. Under the microscope, your expert surgeons at Global Medical Institute free your nerves and blood vessels using tiny instruments and a very precise approach. After surgery, your eyelids may be a little swollen for a few days. Simply apply ice to relieve the swelling.

What happens after frontal decompression?

You can continue to take your medication in case of crisis after surgery. The tiny sutures will be removed 5 days after surgery. Scars are quickly invisible. Pain attacks become progressively less severe over a period of around 3 months.

Your expert doctors at Global Medical Institute will follow you step by step throughout the post-operative phase, giving you all the information you need to make your convalescence as rapid as possible.

Normal activities can be resumed 5 days after the operation, physical activities around 3 weeks after the operation.