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C2 neuralgia CommunityC2 neuralgia ArticlesRevolutionary Migraine Treatment Only at Georgetown
Revolutionary Migraine Treatment Only at Georgetown Print E-mail
Written by huskyboys   
26 January 2010
But now a revolutionary new treatment is offering some headache sufferers dramatic improvement, while actually curing others
http://www.georgetownuniversityhospital.org/body.cfm?id=555836
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Revolutionary Migraine Treatment Only at Georgetown

Anyone who has ever suffered through a really bad headache can only imagine the misery of migraines. The pain can be debilitating, sometimes sending victims to bed for days. In its worst cases, sufferers even end up in an emergency room or are hospitalized for dehydration from vomiting.

Despite the advent of new drugs and complementary therapies, serious headaches often elude medicine's best attempts to resolve them. Frustrated by a lack of progress, some physicians add insult to injury by dismissing their patients' complaints.

But now a revolutionary new treatment is offering some headache sufferers dramatic improvement, while actually curing others. And it's only available at Georgetown University Hospital, where plastic surgeon Ivica Ducic, MD, PhD, perfected the technique.

What does plastic surgery have to do with headache relief? The answer depends upon the source of the pain, according to neurologist Pamela Blake, MD, Director of Georgetown's Headache Clinic and a colleague of Dr. Ducic.

"The term 'migraine' has actually been used as a catch-all for any severe, persistent and recurring headache," she says. "But we now know that one type of headache is caused by neuralgia which arises when a nerve is compressed or restricted by surrounding structures. In those instances, Dr. Ducic's approach can work wonders."

As Chief of Peripheral Nerve Surgery, Dr. Ducic took the skills and techniques he has relied upon in other procedures and applied them to the nerves in the neck, temples and forehead of headache sufferers. The most common offending nerve lies in the occipital area, near the head and neck juncture.

"We don't actually operate on the nerve at all, but open up the space or widen the muscle that surrounds it," he says. "This, in turn, reduces and sometimes even eliminates the pressure that caused the irritation, inflammation and pain in the first place."

That was certainly the case for Linda Callahan, 54, who suffered with severe headaches for 17 years. Dr. Blake, Callahan's headache specialist since 2003, tried everything to relieve her escalating pain. While some approaches such as beta blockers or injections would work for awhile, eventually they, too, failed. At that point, Dr. Blake suggested that Callahan consider Dr. Ducic's new technique.

"I asked Dr. Blake what she would do if she were in my shoes," the federal employee says. "And her answer was 'I'd have the surgery. You have so much to gain and so little to lose.'"

The two-hour, outpatient procedure is performed under general anesthesia with only a small incision at the hairline. Most patients return home the same day, with a sole discharge instruction of "taking it easy" over the next two weeks. Unlike previous surgical attempts, nerve decompression does not preclude other options if for some reason it's not effective.

But judging from initial results, the procedure is effective indeed. Over the last 12 months, Dr. Ducic has performed the nerve decompression surgery in 75 headache patients, with 50 to 75 percent of them reporting significant improvement. Some patients, like Callahan, are completely or almost headache-free.

"I haven't had a migraine since my operation on November 18, 2005 – four days after my birthday," she says. "What a gift that has been!"

According to Dr. Ducic, it's usually straightforward to determine who may be a candidate for nerve decompression – all he has to do is touch the area and watch the patient's response. In addition to tenderness, there are other, more subtle clues. Occipital neuralgia is usually marked by constant or frequent pain, while migraines tend to come and go. True migraines are often triggered by stress, light, noise, and changes in the weather, and are often preceded by the tell-tale aura. But some headache patients appear to suffer from a combination of causes – both occipital neuralgia and migraines.

The key to relief is the right diagnosis, followed by the right treatment.

"Specialists have made a lot of progress in unraveling the mysteries of headaches over the last few years," says Dr. Ducic. "If a headache sufferer is not getting better with treatment, it's to his or her benefit to seek another opinion. While there is no single magic bullet, we can help almost anybody."

For more information about this surgery or to schedule an appointment with Dr. Ducic, call Georgetown MD at 202.342.2400 to speak with one of our nurse counselors.

 

 

 
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