Salient Points

• Scalding of the forehead in an attempt to treat frontal migraine headaches (MHs) during the 10th century is the first ablative measure.

• Surgical attempts to mitigate MHs date back to 1923 when Jonnesco first removed the stellate ganglion.

• Walter Dandy removed the inferior cervical and first thoracic sympathetic ganglions in two patients in 1931. Dickerson described success with ligation of middle meningeal artery in 1932.

• In 1946, Rowbotham reported success with operation in three cases obtained by periarterial sympathectomy at the carotid bifurcation and excision of the superior cervical ganglion combined with ligation of the external carotid artery.

• Resection of the greater superficial petrosal nerve for the treatment of various types of unilateral headaches was suggested by Gardner et al in 1946.

• Total resection of the trigeminal nerve within the cranial base (trigeminal neurectomy) has also been tested. However, the morbidity was prohibitive.

• Murillo, in 1968, suggested removal of the temporal neurovascular bundle for treatment of MHs.

• An occipital neurectomy was suggested for patients with occipital MHs and neuritis by Murphy in 1969.

• In 1992, Maxwell reported trigeminal ganglio-rhizolysis for treatment of MHs in eight male patients through percutaneous radiofrequency.

• A retrospective study to validate the observation by patients that their headaches had disappeared after a forehead lift was completed in 2000 by Guyuron.

• The first prospective pilot study to demonstrate the role of supraorbital and supratrochlear trigger site deactivation was published by Guyuron in 2002.

• The role of single site botulinum toxin injection was report by Behmand and Guyuron in 2003.

• Dirnberger confirmed Guyuron’s findings with a prospective study in 2004.

• The first randomized prospective study in surgical treatment of MHs was published in 2005 by Guyuron et al.

• Poggi also confirmed Guyuron’s findings in 2008.

• The first prospective randomized migraine surgery study including sham surgery was reported in 2009 by Guyuron et al.

• The long-term efficacy of migraine surgery was documented by Guyuron’s team with a 5-year follow-up study in 2011.

• For the first time, Guyuron, through a collaborative effort between three departments and using proteomic analysis and electron microscopy, demonstrated that patients who have MHs have myelin deficiency in 2014.

• The first retrospective study demonstrating the efficacy of surgical treatment in adolescent patients was completed in 2015.