Who is Suitable?

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Anchor lead: How can people who are considering surgery for headache be evaluated? Elizabeth Tracey reports

Chronic headaches that develop after trauma or injury can sometimes be alleviated with a surgical procedure, but careful evaluation is needed beforehand. Sashank Reddy, a craniofacial surgeon at Johns Hopkins, describes the process.

Reddy: There are imaging studies that have been done including at Johns Hopkins to help us to understand what can happen to individual nerves in response to trauma or even in other causes of chronic headache. But I would actually say that the most reliable tests here are actually old-fashioned physical exam identifying those trigger points, as well as the response to transient nerve blocks. So these are medicines that numb those nerves or decrease the swelling or inflammation around those nerves for a while, and when patients benefit from those then we know that this is one of the important triggers.  :30

Reddy says every evaluation should start with a neurologist who specializes in headaches, and that the most conservative approaches should be tried first before surgery is undertaken. Those who do choose surgery are likely to get durable results, Reddy notes. At Johns Hopkins, I’m Elizabeth Tracey.