Therapeutic Role of Fat Injection in the Treatment of Recalcitrant Migraine Headaches

Caviggioli, Fabio; Maione, Luca; Vinci, Valeriano; Lozito, Alessia; Tinterri, Corrado

doi:10.1097/prs.0000000000006353

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…64 Injection of autologous fat, harvested from the abdomen or lateral thigh, may be used as an adjunctive therapy with relatively minimal side effects or complications. 9,65 Fat injection is indicated in case of diffuse residual pain after initial surgery. If the symptoms are not completely eliminated after two rounds of fat injection, or if there is no symptom relief after the first round of fat injection, other procedures are indicated.…”

Section: Resultsmentioning

confidence: 99%

Secondary Trigger Point Deactivation Surgery for Nerve Compression Headaches: A Scoping Review

Saffari,

Janis

2024

Plastic and Reconstructive Surgery - Global Open

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Background: Primary trigger point deactivation surgery has been successful in reducing or eliminating nerve compression headaches between 79% and 90% of the time. The aim of this review article was to discuss the factors that contribute to index trigger point deactivation surgery failure, the importance of reevaluating trigger points following failure, and the options for secondary surgery. Methods: A literature search was performed using a combination of keywords involving “chronic headache” and “nerve deactivation surgery,” in databases until February 2023. Results: Data of 1071 patients were evaluated and included (11 articles). The failure rate after index trigger point deactivation surgery occurs is approximately 12%, primarily due to incomplete primary trigger point deactivation. Secondary trigger points may not appear until the primary trigger is eliminated, which occurs in 17.8% of patients. Reevaluation of previously diagnosed trigger points as well as uncovered trigger points and additional preoperative testing is indicated to help determine candidacy for further surgical deactivation. To address scarring that could contribute to failure, corticosteroid injection, acellular dermal matrix, adipofascial fat, or expanded polytetrafluoroethylene sleeves have been described with beneficial effects. For neuroma management, regenerative peripheral nerve interface, targeted muscle reinnervation, a combination of both, relocation nerve grafting, or nerve capping have also been described. Neurectomy can be performed when patients prefer anesthesia and/or paresthesia over current pain symptoms. Conclusion: Secondary trigger point deactivation surgery is indicated when there is suspicion of incomplete deactivation, internal scarring, neuroma, or newly-diagnosed trigger points.

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Section: Resultsmentioning

confidence: 99%