Causal relation between nerve compression and migraine symptoms and the therapeutic role of surgical decompression

Background: Nerve decompression has been recently described as a therapy for migraine headaches. Multiple studies have demonstrated significant symptomatic relief or complete resolution of migraine symptoms in patients with surgical decompression. However, there is no study describing a causal relation between migraine headaches and nerve compression and resolution of symptoms with tumor removal and nerve decompression. Methods: We were presented with a biological example of compression neuropathy causing migraine headaches due to greater occipital nerve compression by a lipoma from a remote head trauma. Included is a literature review of nerve decompression therapy for migraine. Results: Migraine symptoms were completely resolved on removal of the mass and nerve decompression. The patient has not required any migraine medications since the surgery. Conclusions: This case serves as a biological example to validate the true causal relationship between greater occipital nerve compression and migraine headaches.