Surgical Treatment of Frontal and Occipital Migraines: A Comparison of Results

METHODS We performed a retrospective comparison between 2 surgical procedures: our modified technique of selective endoscopic myotomies of corrugator supercilii, depressor supercilii, and procerus muscles6–8 for frontal migraine (group A) versus the surgical isolation of the greater and the lesser occipital nerves for disease originating on the posterior region (group B). Both procedures were performed under local anesthesia as 1-day surgery. Group A was constituted by 43 patients who, after a 1.5-cm long midline scalp incision (Fig. 1) and subgaleal dissection, underwent selective myotomies and decompression of the supraorbital and supratrochlear nerves. In group B, 22 patients, after an 8-cm-long scalp incision along the superior nuchal midline (Fig. 2) and dissection of local muscles, underwent release of the greater and the lesser occipital nerves by ligation of the (usually dilated) occipital vascular bundles. For both groups, followup ranged from 6 to 24 months.