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Research focus: Chronic cluster headache (CCH) is a pathological entity leading to a severe degree of disability. It is characterized by pain attacks occurring daily or spaced out by remission periods of <1 month, contrarily to the episodic form. When the condition results to be refractory to conservative treatments (both prophylactic and abortive treatments) and when such condition is present for at least 2 years, surgical treatment is suggested. Research methods: We here report our institutional experience with regard to both occipital nerve stimulation (ONS) and deep brain stimulation (DBS) for the treatment of the disease. Results/findings of the research: 15 out of 28 (65%) patients submitted to ONS had ≥50% reduction in 32 headache number per day and were considered responders; 12 out of 17 patients (70%) submitted to phyp DBS showed long-last improvement. Main conclusions and recommendations: Although no valid predictive factor is available at the moment, due to the lack of prospective and randomized studies, both procedures seem to constitute safe and valid treatments for such disabling condition.

ONS and DBS for the Treatment of Chronic Cluster Headache