Causal Relation between Nerve Compression and Migraine Symptoms and the Therapeutic Role of Surgical Decompression

BACKGROUND Nerve decompression has been recently described as a therapy for migraine headaches. Multiple studies have demonstrated significant symptomatic relief or complete resolution of migraine symptoms in patients with surgical decompression. However, there is no study describing a causal relation between migraine headaches and nerve compression and resolution of symptoms with tumor removal and nerve decompression. METHODS We were presented with a biological example of compression neuropathy causing migraine headaches due to greater occipital nerve compression by a lipoma from a remote head trauma. Included is a literature review of nerve decompression therapy for migraine. RESULTS Migraine symptoms were completely resolved on removal of the mass and nerve decompression. The patient has not required any migraine medications since the surgery. CONCLUSIONS This case serves as a biological example to validate the true causal relationship between greater occipital nerve compression and migraine headaches.