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Brain surgery to relieve headaches

Fergus Walsh | 09:57 UK time, Friday, 17 December 2010


Your headaches have got to be pretty bad to allow someone to drill a hole in your skull and then insert an electrode deep into your brain. That is what Barrie Wilson did. He suffers from cluster headaches, considered to be among the most excruciatingly painful of all medical conditions.

The procedure took place at the National Hospital for Neurology and Neurosurgery at Queen Square in London. Not only did Mr Wilson allow the surgical team to drill into his head, but he was awake throughout the operation. Fortunately, he did not feel any pain. A local anaesthetic numbed the scalp, and the brain has no sensory nerve endings.

Mr Wilson is one of those stoic individuals who refuses to be bowed down by what life throws at him. For years he had suffered daily bouts of horrendous headaches often lasting several hours. Yet he refused to be cowed into submission.

He said: "The last 14 years have been torment. I did not know from day to day, or from hour to hour, when I would get an attack, but you cannot let it beat you otherwise you may as well go into a corner and die. You must be strong-willed."

Dr Manjit Matharu is Mr Wilson's neurologist. "About one in 1,000 people suffer from cluster headaches, and a small proportion of these fail to respond to medication. They are living in agony - these are also known as suicide headaches because some people choose to end their lives rather than face the pain."

Given what he was going through, it is perhaps no surprise that Mr Wilson opted for deep brain stimulation.

I get the opportunity to witness many fascinating - and sometimes gruesome - operations but this one was especially interesting.

The neurosurgeon, Ludvic Zrinzo, wore a red cap bearing the motto: "Brains are Beautiful". Well I guess he should know as he sees them every day. Mr Zrinzo had to insert the probe about 8-9cm into the brain into the posterior hypothalamus - the area which triggers the headaches.

"How accurate do you need to be?" I asked.
"We like to be within 1mm of the target" he replied.

And he was. That is quite something. The electrode is connected to a pacemaker which emits a low electric current. This stimulation aims to block the damaging signals which trigger the cluster headaches.

Throughout the operation Barrie Wilson remained calm and seemingly at ease.

He said: "I felt no pain whatsoever. It was like going to the dentist - you expect pain but then it doesn't hurt. It was a surreal experience."

For Mr Wilson the treatment has been a huge success. Nearly four months after surgery, he has suffered just one headache and feels he has got his life back.

He said: "The only thing that used to ease the pain was pure oxygen. I needed to inhale this as soon as a cluster headache began otherwise it would last for hours. That meant I had to carry an oxygen tank everywhere, and so could do nothing on the spur of the moment. Now my wife and I are hoping to go to New Zealand to see two of our grandchildren. It's great."

Drilling holes in skulls - trepanning - is one of the oldest medical procedures, dating back thousands of years. Of course deep brain stimulation is a lot more sophisticated. The surgical team have MRI scans to guide them. The electrode used is made of titanium alloy. It is all hi-tech stuff. Yet the moment they started to drill into Mr Wilson's skull it didn't feel very hi-tech.

Our knowledge of the brain is more advanced than ever, but according to surgeon Ludvic Zrinzo, there is still a huge amount we don't know: "The brain is the final frontier. If you look at the number of neurons, synapses and connections, these vastly outnumber the stars in our galaxy, and we won't understand all the complexities for many generations to come."

Update: 20th December 22.05

Thanks for your comments on this remarkable story. A quick update on the brain and whether it can feel pain. I asked for further guidance from the neurosurgeon in this case, Ludvic Zrinzo. Since he spends his time doing brain surgery, I guess he should know...

He said: "The brain has no sensory nerve endings. Pain is felt when sensory nerve endings in the skin and other part of the body are activated by extreme hot /cold /pressure etc and transmit a pain message to the brain that is then interpreted as pain. Lack of sensory nerve endings in the brain means that manipulation of the brain itself does not result in pain."

Comments

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  • 1. At 2:16pm on 17 Dec 2010, sensiblegrannie wrote:

    Surreal indeed! Are cluster headaches and migraine headaches the same thing?

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  • 2. At 3:46pm on 17 Dec 2010, toflustus wrote:

    "and the brain has no nerve endings."
    Really?!

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  • 3. At 7:24pm on 17 Dec 2010, robninja1 wrote:

    Dear Furgus,
    Thank you for your excellent report on deep brain stimulation. My names Rob and it was very exciting for me to see this on national television as I'm currently applying for the same operation.

    I suffer from a condition called anesthesia dolorosa which leaves me chronic pain after being assulted and then failed surgery in Feb 08. Seeing Barrie Wilson have the operation successfully for a similar chronic pain is not only brilliant for him, it also helps me because it proves that the operation can work.

    Many thanks again because you've told so many people about the possibilities of this amazing proceedure.

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  • 4. At 8:13pm on 17 Dec 2010, smokey wrote:

    This is the best news I have had in years. My husband has been in constant head pain for 26 years. He is often unable to do the most normal of things as his eyes are running and his head is throbbing. Socialising is a nightmare. No tablets work. He has been desperate for pain relief for years. I reckon this hospital will have lots of people like him at their doors begging for help.

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  • 5. At 10:01pm on 18 Dec 2010, RenĂ©e Mineart wrote:

    To answer sensiblegrannie, no they are not, I suffer from both (which is very rare), and they are VERY different. Clusters are MUCH worse. My migraines last days, 5-7 days sometimes. My clusters last 10 to 30 minutes, sometimes longer, but are many times more painful than a migraine. And the after-affects can take hours to go away and recover from. Combined, and with the daily chronic headaches I get, they devastate my life at times. My longest period of near continuous pain lasted 7 months. This report is nothing short of AMAZING!

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  • 6. At 4:05pm on 19 Dec 2010, GeoffWard wrote:

    Brain surgery to relieve headaches (Fergus Walsh | 09:57 UK time, Friday, 17 December 2010)

    "...and the brain has no nerve endings."
    .....................

    Really

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  • 7. At 2:13pm on 20 Dec 2010, MikeK wrote:

    Great story, I hope Barrie continues to enjoy a headache free life. I have suffered similar symptoms for the past 25 years & am desperate for a miracle like this; having a constant daily headache gradually wears you down to a point where you think you can no longer carry on. I will be speaking with my friendly neurologist as soon as possible !

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  • 8. At 9:45pm on 20 Dec 2010, John Ellis wrote:

    It would be interesting to see how this small charge effects the brain chemistry. We know it works and works well but why. does it promote faster neural breakdown of the chemical transmitters, as it is also said to work for some forms of depression and hopefully bi polar disorders. which personaly Id be up for once more is known about the effects on the chemical balances it brings about. One thing I would worry about though is cell calcification through over stimulation via electrical pulse technology. As some has shown up in previous animal tests of this type of tech.

    But on the whole this is interesting.

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  • 9. At 08:10am on 22 Dec 2010, KHALIL wrote:

    hi im khalil from emirates.doctor wilson my head so pain in 24 hours 3 hours like this...baining like some big stone up of my head...thanks...khalil khan...........

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  • 10. At 4:26pm on 16 Jan 2011, jan wrote:

    I have recently been diagnosed with cluster headaches after suffering many years from headaches. over the last couple of years my headaches have got worse and the only relief i get is when i have to take an injection but sometimes it doesnt last very long and so have to take another injection after an hour of taking the first one. As you can only take 2 injections in a 24 hour period, if i get another headache during that time i am stuffed. I am on high flow oxygen to try and get rid of the excruciating pain but sometimes this only takes the edge off. This problem is starting to affect my job and even though my work colleagues seem ok about it,I know deep down that they dont understand what I am going through. Can anyone help me. Thanks Jan

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  • 11. At 09:38am on 25 Mar 2011, riv wrote:

    my husband has suffered 4 15 years with severe cluster headaches he has bn on imigran sumatriptan succinate injections he has bn on steroids he has had oxygen everthing he has tried hasnt worked the doctor says hes never heard of the operation his neuroligist says he doesnt need 2 c him any more last week it was that bad he said he wasgonna commit suicide we need help can u help plzzzzzzzzzzzzz

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  • 12. At 10:55am on 25 Mar 2011, Central Communities Team wrote:

    If someone close to you seems like they might be distressed or suicidal, you can help them by suggesting that it could make all the difference to talk to their GP/ doctor, or to someone who is trained to help. Medical professionals and counsellors will be more equipped to help them deal with the problems that they are experiencing. The Samaritans Telephone: 08457 90 90 90 Website: http://www.samaritans.org/index.shtm Email: jo@samaritans.org Text: 07725 90 90 90

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  • 13. At 3:49pm on 27 Mar 2011, riv wrote:

    2 answer ur comment on seeing his gp dont u think he has already done that 4 the last 15 years but he doesnt seem 2 want 2 no his neuroligist said he doesnt need 2 see him who else can he turn 2 ?

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  • 14. At 08:42am on 26 Apr 2011, Olotu wrote:

    Wt a good innovation!

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  • 15. At 1:50pm on 13 Jun 2011, Vinko Rajic wrote:

    I can use telepathy.
    I can exchange voice, video, smell, people can move small move muscles on my body from distance and more.
    Crazy but over 80% of all telepathic experiences are the same like for Schizophrenia.
    I never found any document about any other existing person in human history like myself, but
    science never did serious research on me and I actually did not exist in world of science.
    I could easy give evidence for telepathy.Maybe some of Neurologist or scientist
    could help me or is maybe interesting to make research on my phenomena.
    Do you have any advice, how can I make test on telepathy and confirm it?

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