STRATEGY FOR SELECTING THE EXTENT AND STAGING OF SURGICAL TREATMENT IN COMBINED FORMS OF CHRONIC MIGRAINE
Keywords:
chronic migraine, combined forms, surgical strategy, staged treatment, trigger zonesAbstract
Background. Combined forms of chronic migraine are characterized by multifactorial pathogenesis involving multiple trigger zones, which significantly complicates the selection of optimal surgical tactics. One-stage surgical interventions without hierarchical assessment of trigger zones often result in unstable clinical outcomes and recurrence of pain.
Objective. To develop and clinically substantiate a strategy for selecting the extent and staging of surgical treatment in patients with combined forms of chronic migraine.
Materials and Methods. Surgical outcomes of patients with chronic migraine involving multiple trigger zones were analyzed. In the main group, surgical tactics were based on hierarchical assessment of trigger zones, identification of the dominant pathogenetic mechanism, and implementation of a staged surgical approach. The results were compared with those obtained using traditional one-stage surgical treatment.
Results. The staged surgical strategy reduced the rate of unjustified extensive interventions, improved the stability of clinical outcomes, and decreased the risk of pain recurrence. A lower frequency of repeated surgeries and postoperative complications was observed, along with increased predictability of treatment results.
Conclusion. The proposed surgical strategy for combined forms of chronic migraine enables individualized treatment, reduces surgical trauma, and improves clinical outcomes, supporting its implementation in specialized surgical centers.
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