‘How surgery helps in tackling migraine’

Dr. Al-Amin Ahmed Dahiru is a specialist migraine surgeon and founder of the Migraine and Vascular Surgery Centre, Abuja. He pioneered migraine surgery, the new alternative treatment of chronic migraine headaches in the country.

Also a Germany-based consultant in General and Vascular Surgery, Dahiru in this interview speaks on myths surrounding migraine, and benefits of surgery among others.

What is migraine?

Migraine is not just a mere headache. It is a complex condition with a variety of symptoms ranging from pain to disturbed vision.  It affects everyone differently and an individual’s experience of the condition can change over the years. The symptoms range from pulsating headache on one side of the head, to pain when combing hair, to sensation of numbness and even difficulty speaking.

Despite its prevalence, there are so many misconceptions about migraine; some people say it only affects women, while some say it affects people who are just afraid of diseases. The real origin of headache is what is not clear up till now.

Headache itself is just a symptom of migraine so you can have headache with malaria, and any other thing but real migraine is any headache that last more than 72 hours.  Although the pain associated with migraines is excruciating and can significantly impair quality of life, most people who live with migraines suffer in silence.

The two most common forms of migraine are Simple migraine and Classical migraine.

For Classical migraine you know when the headache is coming, you start yawning, having stress, neck pain, and later the headache. Those who are enlightened know when to take medicine for this type.

Simple migraine on the other hand, you don’t know when it is coming. It can start as soon as you start traveling, and last for 72 hours; even if you take medicine it will not go, it must last this period.

The origin of this kind of migraine is not really clear. So in migraine surgery, we target the triggered areas most patients complain about. Some have it on their forehead, ear, throbbing, and for some at the back of their head.

Migraine dates as far back as 4,000 years ago. The word migraine comes from the Greek word ‘hemicrania’. And means ‘half headed’, because of the stabbing pulsating pain that is frequently experienced on one side of the head.

 How prevalent is the disease in Nigeria?

Currently in Nigeria, I think migraine status is around 12 to 14%. So many migraine patients are hidden, at some point they don’t really want to come out and say they have migraine because people don’t really believe them anymore.

Almost 70% of migraine patients don’t go to doctors anymore because they are already used to the same treatment.

Even in medical schools, young children have had patients who have been out of school because of migraine. Is migraine genetic?

Yes, there are high chances that if any of the parents is having migraine there are chances that their children or offspring will have migraine.

Can migraine be prevented? 

Yes, prevention in the sense that, when you know what triggers it then prevent the attack.

What are the common triggers?

There are many triggers, some people get triggers from smell or food. You can have migraine from red wine and not from white wine, from sunlight and from stress. There are people who have the attack as a result of menstrual pain and when they reached the stage menopause, the migraine will go.

What inspired you into establishing a Migraine and Vascular Surgery Centre in Nigeria and pioneering migraine surgery?

I went for a specialty programme in vascular surgery in Germany. Vascular surgery has to do with pains with stroke patients and in between my career, I came across migraine surgery. I came across it because of a relative of mine that had been suffering from migraine for over 30 years.

I took her to Germany for treatment, and found the migraine surgery centre there. I met a professor who told me about the whole procedure and he gave her a testing injection to see if she could react to it. The injection lasted for 10 weeks and she had tremendous relief from the migraine. So that injection was the first step in determining if the patient is suitable for the next step which is surgery. It is either you get the injection for 10 weeks, or you do the surgery which will lasts a life time.

When my relative got better, I decide to do a fellowship programme in the migraine surgery centre in Germany and then decided to bring the whole idea back home by establishing a centre at Nisa Premier Hospital.

And at the moment, I have performed migraine surgery in some hospitals here in Abuja, and I visit patients on regular basis. My first consultation had over 100 patients and up till now I keep receiving new patients with complaints on migraine.

We don’t just see patients who have minor headaches. We also see patients with chronic headache. Anyone who has up to 15 days of headache, in a month, should come and see us. We will do our best to improve their quality of life. And so far so good, we have brought the treatment to this part of the world.

What is the surgery like?

It is not what people should be scared of. It is a surgery around the scalp area. The surgery is completely new in Nigeria. It actually started as an old practice among Egyptians. The Egyptians cut the nerves of the arteries to relieve pain. Earlier on they thought it was only those vessels so if they see them they will just cut them and some patients have relief. It was later discovered to be more than just vessels. There are nerves involved and they comprise of muscles.

It started through cosmetic surgery, the Hollywood actresses when they’re getting older, go to hospitals to do plastic surgery. They get injected in several parts of their faces so most of them keep coming back and say they have headache. So that was when the research started and we found out that there are trigger areas which the doctors themselves didn’t know but they kept injecting them for cosmetic reasons not knowing that they are relaxing the muscles but compressing the nerves.

Then the advanced surgery started in the US, in Germany, UK and other parts of Europe.

What we have at the centre will stem medical tourism; the spending of money on flights, accommodation, and other bills in travelling abroad for medical treatment.

I discussed with the professor doing the procedure in Europe, and we decided to collaborate with them at the centre in Nigeria.

Only around 40 percent of migraine sufferers are diagnosed correctly and 70% of them do not receive appropriate treatment. Many people are suffering from migraine in the villages thinking it is spiritual attack from stepmothers, and taking herbal medicines that affect their kidneys.

With migraine surgery, you don’t need to take medicine for life anymore. That is why we decided to bring it back home, and we are trying to expand it from Abuja to Lagos and other parts of the country. We have also received patients from other parts of West Africa.