In March and April of this year I had craniotomies on each side of my head to clip a total of three significant aneurysms – leaving this bald guy in his 50s with 18 inches of scars. Fun, but better than the apparently imminent alternative. Anyway: before all this I had suffered migraines most of my life and used Rizatriptan Benzoate (RB) to treat them successfully. However, my surgeon, six months after the second surgery, is still advising against using RB – leaving me with “untreatable” migraines. Has anyone else experienced this? And does anyone have ideas for alternative medications (drugs, not herbal, these are severe migraines) that can be used after aneurysm surgery? Thanks…
Are you seeing a headache specialist? I would ask the physician who prescribed RB if there is an alternative. In the meanwhile, are there triggers that cause your migraines ie. certain lights or other environmental triggers? BTW, after your surgery, has your migraines improved?
I’ve seen so many specialists this past year I’m not that keen on seeing another one. 
But I may have to. Physician seems unsure, cowed I think by all the brain surgery I’ve had. And no, no environmental triggers; they just seem to come at random and have done since I was in college. Have they improved since surgery? Well, beforehand I had been getting an increasing number of headaches (not migraines) in random parts of my head, some of them pretty severe – migraines without all the other stuff. I would say that those have declined significantly since surgery, and that I’ve probably had fewer migraines. That said, many days I wake up with a headache that my neurosurgeon believes is related to recovery from the craniotomies.
Peterh,
After my hospital discharge, I had severe head aches non-stop for about 6 weeks. I was prescribed Perocet which I tried to aggressive ween off as I did not want to be addicted. About 4 months later, I was diagnosed with Vestibular Migraine where was constantly dizzy. (I did not feel pain but vertigo). The Headache specialist told me that Percocet is not good treatment for Migraines. Perhaps, your Neuro-Surgeon can prescribe Norco or Percocet to deal with headaches from the surgery. For Migraine, seems to be a be a challenge as it does not look like environment triggers (ie. certain light sources or smells) the migraine. BTW, I can relate seeing multiple physicians. Often they do not talk with each other and I had to do all the coordination between them. It is really challenging saying it mildly. But, I would still ask the original physician who prescribed RB and ask him for an alternative. Then, you have to ask your Neuro-Surgeon whether you can take it. I use sound therapy to deal with migraines.
Peter, I had a rupture and like 2fight suggested to you, I cleared everything through my neurosurgeon. After rupture I had debilitating headaches and was told by neurosurgeon to see a neurologist. He tried some different medications that I didn’t tolerate well. The neurologists calls them migraines. He then suggested a sphenopalatine ganglia block. There are different methods of delivering the lidocaine. I understand there are some anesthesiologists who are finding great results for some. My neurologist says he has about an 80% success rate. Sometimes I believe success rates are equal to expectations. I’ve had it twice about a year apart. I think it was a bit over a year before my first block and then had one again this year. My insurance does cover it. I drive to my local hospital, listen to good music, tell a few jokes, little bit uncomfortable but I get to drive home
The Dr uses a small nasal catheter on me. I wouldn’t have gone with a swab or needle based on what I’ve read, but that’s me.
Here’s a link https://americanmigrainefoundation.org/find-a-doctortreatment/treatment/sphenopalatine-ganglion-blocks-in-headache-disorders/
Just a tool to consider, I also decreased caffeine which helped some.
Hi Moltroub, many thanks, that’s an interesting approach – although more invasive procedures are high on my wishlist right now. That said, I will definitely investigate, because I need to find a fix for this.
Hi Peter, I too use to use RB prior to my rupture and crainiotomy and like you the neurologist I see for the migraines and insomnia will no longer let me use it. Fioricet and other migraine meds do not work for me either. So far the only thing that has worked is Methaprednisolone, a 7 day course of steroids. I dislike the idea of taking a steroid, but it kicks the migraine in the butt within few hours and I’m usully headache free for the 2-3 weeks following. Today is my 3 yr anniversary of my crainiotomy, and I am still searching.
Hey Peter, I feel your pain. I’m six years post crainitomy for clipping on right internal carotid artery. Post surgery I too suffered with horrible daily migraines. Tried to work with neurologist for a year and a half and finally asked for a referral to a headache specialist. They put me on gabapentin and Namenda XR (I had failed 4 previous medications) Finally got them under control. I’m still on the gabapentin, but did wean off the Namenda.
Hang in there, it will get better it’s just figuring out the right combo of drugs for you.
Good luck.
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Hi Laura, thanks for the empathy… Gabapentin is an interesting thought, as is Namenda – I will talk to my doctor about them.