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Back to 2014 Annual Meeting Posters
Early results of peripheral nerve surgery for post-concussion headaches.
Jeremy C. Sinkin, MD1, John M. Felder, III, MD1, Kevin Crutchfield, MD2, Ivica Ducic, MD, PhD3.
1Georgetown University Hospital, Washington, DC, USA, 2Sinai Neurology Associates, Baltimore, MD, USA, 3Plastic Surgery, Nerve & Headache Institute, Washington, DC, USA.
Background - Chronic headaches following concussion are debilitating and difficult to treat. Commonly employed therapeutic modalities include pharmacologic, physical, and psychological interventions. We present our growing experience with peripheral nerve surgery as a novel and effective treatment for post-concussion headaches.
Methods - A retrospective review of 28 consecutive patients with post-concussion headaches who failed medical therapy and underwent peripheral nerve surgery during a 12-month period (January 2012-December 2012) was performed. Surgeries performed included neurolysis or excision of greater, dorsal, and lesser occipital nerves, transection of auriculotemporal and zygomaticotemporal nerves, and neurolysis of supraorbital, supratrochlear, and infratrochlear nerves. Pre and post-operative headache pain was evaluated on visual analog scale (VAS) and statistically analyzed in 21 patients with at least 3 months follow-up.
Results - The mean VAS headache pain reduced from 5.2 preoperatively, to 1.2 (p<.05). 19 patients (90%), had at least a 50% reduction in their VAS following peripheral nerve surgery. Twelve patients (57%) were pain free at time of final follow-up. Mean length of follow-up was 7 months. There were no surgical complications.
Conclusions - Early results indicate peripheral nerve surgery is a safe and effective new therapy for post-concussion headaches in the properly selected patients. Further study is needed to examine the long-term durability of outcome.
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