Treating Severe Headaches with Nerve Decompression

Eric H. Williams MD
Specializing in reconstructive surgery and pain relief in the Greater Baltimore area.

[Dr. Williams]  We are approximately two months from a decompression of the Bilateral Greater Occipital Nerves with resection of the Bilateral Lesser and Third Occipital Nerve in the back of the scalp. This was done for a history of chronic Occipital Nerve Neuralgia. Can you tell us how long you were having headaches in the back of your head prior to coming to see us?

 

[Patient] “It was about seven months. Um, everyday I’d have a headache range from a pain scale of about a four to an eight, um, days where I’d have high stress situation and it would result usually in a chronic migraine where it would go up to a 10 and I wouldn’t be able to be around light, noise, and I’d have to find a place where I would have to go away into a dark room and just try to sleep it off or take medication to get rid of the headache.”

 

[Dr. Williams] And you were taking medications, and you were taking headache medications. How many medications were you taking and did they actually cure your headaches for you?

 

[Patient] “Um, I took between three and five different medications at a time. It wasn’t until we got the heavier medications, I can’t remember what it’s called, the actual migraine reduction medicines, were the only things that could stop it.”

 

[Dr. Williams] Okay, and so, it sounds like these are not mild headaches, these are headaches from a 4 to a 10!

 

[Patient] “Yes”

 

[Dr. Williams] So these are incapacitating and you had them how often? Everyday?

 

[Patient] “Everyday”

 

[Dr. Williams] Um, and he was seen and treated by a colleague Dr. Kevin Crutchfield and had gone through a specific protocol trying to cure these headaches. And when that protocol did not help as much as they had wanted, he was referred for surgical management and we performed the operation on the back of his head. Where were your headaches? Uh, and your neck pain, where was it that you were experiencing the majority of your pain?

 

[Patient] “So, from the back of my neck on both sides, it would feel like someone was stabbing me. And it would wrap around to the front of my head, uh, and go behind my eyes. It felt like a vice grip was just tightening down around my head, just squeezing my head, and my head was feeling like it was going to pop.”

 

[Dr. Williams] Okay, and you are now, um, two months from surgery. What would you say your experience has been since the operation?

 

[Patient] “It’s been amazing, I haven’t had a single headache, no neck pain. There’s some pops and stuff, which is normal, but  besides that, everything has been great.”

 

[Dr. Williams] So, say that again. You have not had a single headache in two months?

 

[Patient] “I have not had a single headache in two months.”

 

[Dr. Williams] And you had headaches every day at a four to an eight?

 

[Patient] “Yes”

 

[Dr. Williams] Would you consider that fairly successful?

 

 

[Patient] “I’d consider that 100% successful.”

 

[Dr. Williams] Okay, very good. Um, anything else that you would like to say or anything – other comments you would like have? Have you noticed any numbness or tingling in the scalp from the areas of the little nerves that we removed? Has that been a major problem for you? Has that affected you in any major way?

 

[Patient] “The first few weeks after surgery it feels a little numb and tingly, but after say three or four weeks it goes away. I’ll still get the tiny tingles and tiny pops in the back of my head and on the top of my head, but besides that it comes and goes. It’s never really consistent.”

 

[Dr. Williams] Okay, and can you tell me if we were able to wean you off your medications – are you currently taking any medications at this time?

 

[Patient] “I’m taking no medications.”

 

[Dr. Williams] Alright, thank you very much!

 

[Patient] “Thank you!”

 

[Dr. Williams] So, do you have any other comments that you’d like to share regarding this procedure and how it has affected you?

 

[Patient] “This procedure has changed my life I was in pain everyday and no I’m in no pain. The scars heeled up great! If you’re even thinking about getting this surgery, I definitely recommend doing it! It’s changed my life and it can change yours. Thank you”