What to Do About Headaches After Moyamoya Surgery

Understanding Post-Surgical Headaches Following Moyamoya Treatment

Headaches after Moyamoya surgery are relatively common and can vary in intensity and cause. It's important to understand that not all post-operative headaches are a cause for concern—many are a normal part of the healing process. During surgery, procedures such as craniotomy (opening of the skull) and scalp incisions can lead to localized pain and discomfort. This type of pain is typically due to tissue trauma and nerve irritation caused by surgical manipulation.

Normal Pain vs. Warning Signs

Mild to moderate pain in the days following surgery is expected and usually peaks within the first few days before gradually improving. Most patients find relief within two weeks as the body begins to heal. Doctors often prescribe short-term pain medication during this period to enhance comfort and support recovery. As inflammation decreases and incision sites begin to close, the need for pain relief typically diminishes.

Potential Causes of Persistent or Severe Headaches

In some cases, headaches may be linked to changes in intracranial pressure. Following revascularization surgery, increased blood flow to the brain can temporarily alter cerebral perfusion, leading to a sensation of fullness or throbbing pain. Additionally, certain surgical techniques—such as temporal muscle apposition or encephalomyosynangiosis (EMS)—involve placing muscle tissue against the brain surface to promote new vessel growth. This can create mild pressure on the dura or surrounding tissues, contributing to localized discomfort.

When to Seek Medical Attention

While most headaches resolve naturally within 10 to 14 days, it's crucial to monitor symptoms closely. If headaches persist beyond the initial recovery phase, worsen over time, or become severe and debilitating, further evaluation is necessary. Other red flags include nausea, vomiting, vision changes, confusion, or neurological deficits such as weakness or speech difficulties.

Patients experiencing these symptoms should contact their neurosurgical team immediately or visit an emergency facility. Imaging studies like CT scans or MRIs may be required to rule out complications such as hemorrhage, edema, or unexpected pressure changes within the skull.

Tips for Managing Discomfort at Home

To support recovery and minimize discomfort, patients are encouraged to follow their doctor's post-op care instructions carefully. This includes maintaining proper hydration, avoiding strenuous activity, managing stress levels, and getting adequate rest. Over-the-counter pain relievers may be used if approved by a physician, but self-medication without medical guidance should be avoided.

Most individuals report significant improvement in headache symptoms within the first month after surgery. With appropriate monitoring and timely intervention when needed, long-term outcomes for Moyamoya patients remain highly favorable.