Журнал неврологии и нейрохирургических исследований / Journal of Neurology and Neurosurgical Research 7-tom 1-san (2026)
PATHOGENETICALLY BASED ALGORITHM FOR CHOOSING SURGICAL TACTICS FOR CHRONIC MIGRAINE: RESULTS OF CLINICAL IMPLEMENTATION
Асадов Х.Ф, Охунов А. О, Асадов Х.Х
Annotaciya
ABSTRACT Background. Chronic migraine is a highly disabling condition with a significant proportion of patients refractory to conservative treatment. The absence of a standardized approach to differential diagnosis of trigger zones and surgical decision-making leads to variability in clinical strategies and inconsistent treatment outcomes. Objective. To develop and clinically evaluate a stepwise algorithm for differential diagnosis and selection of surgical strategy in patients with chronic migraine. Materials and Methods. A single-center clinical study was conducted in patients with chronic migraine resistant to pharmacological therapy. All patients underwent a structured clinical and instrumental assessment aimed at identifying the dominant trigger zone and selecting the optimal surgical strategy according to the proposed algorithm. Results. Implementation of the algorithmized approach improved the accuracy of dominant trigger zone identification, reduced the rate of unjustified and ineffective surgical interventions, and enhanced clinical outcomes. A significant reduction in migraine frequency and intensity, decreased need for repeat procedures, and improved predictability of surgical results were observed. Conclusions. The proposed algorithm for differential diagnosis and surgical decision-making represents an effective tool for standardizing the surgical management of chronic migraine and may be recommended for implementation in specialized medical centers.
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