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Stimulation of the Posterior Hypothalamus
for Treatment of Chronic Intractable cluster
headaches: First Reported Series
Franzini A, Ferroli P, Leone M, Broggi, G.
Posted: July 2004  
Neurosurgery 2003;52:1095-1099

Objective:   To describe the results of deep brain stimulation of the ipsilateral posterior hypothalamus for the treatment of drug-resistant chronic cluster headaches (CHs). A technique for electrode placement is reported.

Methods:   Five patients with intractable CHs were treated with long-term, high-frequency, electrical stimulation of the posterior hypothalamus.

Results:   Since this treatment, all five patients continue to be pain-free after 2 to 22 months of follow-up monitoring. Two of the five patients have remained pain-free without any medication, whereas three of the five required low doses of Methysergide (two patients) or verapamil (one patient). No adverse side effects of chronic, high-frequency, hypothalamic stimulation have been observed, and we have not encountered any acute complications resulting from the implant procedure.

Conclusion:   These preliminary results indicate a role for posterior hypothalamic stimulation, which was demonstrated to be safe and effective, in the treatment of drug-resistant chronic CHs. These data point to a central pathogenesis for chronic CHs.