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Title: Surgery For CH Follow UP (Part 1) Post by DavidGoldberg on Mar 2nd, 2002, 3:42pm I previously posted a report of my surgical treatment for CH and received a number of responses, questions. Let me try to restate my case history in one article and answer all of the questions in one place. History I am a 58-year-old male with no serious medical problems. In 1990 I had my first CH. It was an acute attack, a number 10 on the kip scale. They began to reoccur at first infrequently, but then began coming in clusters of about a two-week duration, about six times a year. I was treated as needed with 240 mg Verapamil (Calan) twice a day, oxygen 12 l/min for 20 minutes, prednisone, and methylprednilolone DP 4mg (Medrol Dospk). Later I began using 10 mg Maxalt MLT, when it became available, and which was very effective. The intensity of my CH reduced in severity over time to a 5 on the kip scale but became chronic occurring about every other day, but year round. With Maxalt, and occasional oxygen and prenisone, they became a nuisance but not debilitating. Surgery I heard about a surgical treatment for migraine headaches being performed by a local well know plastic surgeon, Dr. Bahman Guyuron. He noticed when doing “forehead lifts” that many of his patients that suffered from migraine headaches found that they disappeared or were reduced in severity. The same result was noted for Botox injections in the forehead. Botox injections were already being used to treat migraines. The benefit of the Botox injections wear off after a few months. Afore head lift involves the resection of the corrugator supercilii muscles. These muscles have almost no use but when removed forehead wrinkles disappear. One of the branches of the trigeminal nerve passes through the corrugator muscle. Dr Guyuron believes that irritation of the trigeminal nerev, and resulting inflammation, is the cause of the migraine headache. Resecting the trigeminal takes pressure off of the trigeminal. Migraine headaches and CH are both vascular in nature, and I speculated that this surgery might also work for CH patients. In fact Dr. Guyuron has treated a few CH patients with the same positive results. I knew this surgery was experimental, but due to Dr Guyuron exceptional reputation decided to try it. No surgery is performed unless the patient receives Botox injections into the corrugator muscle and the headaches cease. During the spring of, 2001 I had my first Botox injections but my CH did not stop over the next 2 months, but did decrease in intensity and frequency. I then had a second series of Botox injection in the summer over a broader area of the forehead. For the first few weeks there was no major improvement but then the CH stopped, and for the next month I had none. Dr. Guyuron also noticed I had a deviated septum, which a branch of the trigeminal nerve also passes through. He decided for my surgery to resect the corrugator muscle, repair the deviated septum and to also cut a branches of the trigeminal nerve on both sides of me head near my “temple” in my hairline. My CH were only on the left side of my head, originating by the temple but resulting in the typical CH symptoms. See next posting for continuation |
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Title: Re: Surgery For CH Follow UP (Part 1) Post by nancyc on Mar 3rd, 2002, 4:24pm Thanks for the info David...even though i am not ready to go that route, i do appreciate hearing about any treatment that is working for a clusterhead....Best of wishes to you... |
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Title: If it was for a clusterhead Post by Ueli on Mar 3rd, 2002, 8:42pm >:( |
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