Surgical therapy for primary headaches: techniques and results

BACKGROUND: Primary headache surgery is based on the concept that several peripheral cephalic nerves may act as trigger points; a complete neurolysis of the involved nerves is the key for obtaining a successful result. The aim of this paper was to detail the surgical approaches for primary headache surgery. METHODS: Three major trigger points were considered: occipital, temporal, and frontal ones. RESULTS: Our approach to perform a correct neurolysis of the occipital, temporal, supratrochlear and supraorbital nerves was detailed. CONCLUSIONS: The reported techniques allowed us to reach an elevate percentage of adequate results, with only a minimal rate of minor complications.