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Effect of stem cell enriched fat injection on recalcitrant migraine headache trigger sites refractory to surgical decompression
Navid Pourtaheri, MD, PhD
Case Western Reserve University, Department of Plastic Surgery
2016-02-01
Presenter: Navid Pourtaheri, MD, PhD
Affidavit:
100% of this work reflects the original work by the resident, Navid Pourtaheri under the supervision of the senior author Bahman Guyuron, MD.
Director Name: Hooman Soltanian, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: After surgical release for migraine headaches (MH) most patients experience significant improvement. For MH trigger sites that persist after surgery, we hypothesize that stem cell enriched fat injection (SCEFI) can provide benefit.
Methods: A retrospective chart review was performed on all patients who underwent one or more migraine surgeries, followed by SCEFI for MH by a single surgeon with at least 12-months follow-up. MH surveys prior to SCEFI were compared to their latest surveys, comparing site-specific responses. A reduction in MH Index (MHI) >10% was considered an improvement.
Results: 23 patients were included with 100% female, mean age of 49 years (range 26-71 years), and mean follow-up of 23 months (range 12.3-41.5 months). A total of 29 sites were injected (mean 1.26, range 1-2 sites per patient); 10 (34.5%) frontal, 1 (3.4%) zygomaticotemporal, 0 rhinogenic (0%), 11 (37.9%) greater occipital, 6 (20.7%) auriculotemporal, and 1 (3.4%) lesser occipital. Overall, 16 (69.6%) patients experienced improvement and 7 (30.4%) experienced complete resolution of MH, compared to 2 (8.7%) with no improvement and 5 (21.7%) with worse MHI after SCEFI. The mean response per patient was 3.1 fewer MH per month (p = 0.163), 3.0 fewer points in intensity (p = 0.001), 8.6 fewer hours per MH duration (p = 0.846), and 20.0 fewer points in MHI (-24.5%, p = 0.382).
Conclusions: For frontal, greater occipital, and auriculotemporal MH trigger sites that do not completely respond to surgical decompression, SCEFI may provide complete relief of MH or a significant reduction in MH intensity.
