Abstract
There is no simple straightforward answer as to the mechanism of migraine surgery. The explanations offered here are an approximation. The fundamental obstacle to a concise outline of how migraine surgery works is the incomplete knowledge of how migraine itself works. Instead, a new interpretation of existing evidence will be presented which, in combination with the assumed mechanisms, might offer a more useful approach to migraines compared with some theories presented in the preceding chapter. Certain terms will appear repeatedly throughout this chapter, for example, sensitization, trigeminal activation, referred pain, and convergence of afferent nerves. This is necessary because some of these notions are the connecting link between different aspects of the story. The concepts of “inside-out” versus “outside-in” concern the route of neural signal trafficking. The artificial antagonism between the view of an exclusively intracranial origin of migraine and the role of extracranial tissues as the site of the instigating stimuli for an attack will be described. The two concepts are not mutually exclusive but rather should be seen as complementing each other in an effort to arrive at a hypothesis about the mechanism of migraine surgery.
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