Interventional treatment for cluster headache: a review of the options.
There is no more severe pain than that sustained by a cluster headache sufferer. Surgical treatment of cluster headache should only be considered after a patient has exhausted all medical options or when a patient's medical history precludes the use of typical cluster abortive and preventive medications. Once a cluster patient is deemed a medical failure only those who have strictly side-fixed headaches should be considered for surgery. Other criteria for cluster surgery include pain localizing to the ophthalmic division of the trigeminal nerve, a psychologically stable individual, and absence of addictive personality traits. To understand the rationale behind the surgical treatment strategies for cluster, one must have a general understanding of the anatomy of cluster pathogenesis. The most frequently used surgical techniques for cluster are directed toward the sensory trigeminal nerve and the cranial parasympathetic system.
Rozen
Todd D
TD
Cleveland Clinic Headache Center, 9500 Euclid Avenue, Cleveland, OH 44195, USA. RozenT@ccf.org
D002985:Clinical Protocols; D003027:Cluster Headache / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D010275:Parasympathetic Nervous System / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D014276:Trigeminal Nerve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery