gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Deep brain stimulation in the treatment of chronic refractory cluster headache: An evaluation of long-term follow-up

Meeting Abstract

  • Assel Saryyeva - Department of Neurosurgery, Medical School Hannover, Hannover, Germany
  • Götz Lütjens - Department of Neurosurgery, Medical School Hannover, Hannover, Germany
  • Hans-Holger Capelle - Department of Neurosurgery, Medical School Hannover, Hannover, Germany
  • Joachim K. Krauss - Department of Neurosurgery, Medical School Hannover, Hannover, Germany

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 105

doi: 10.3205/14dgnc501, urn:nbn:de:0183-14dgnc5012

Published: May 13, 2014

© 2014 Saryyeva et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Cluster headache (CH) is characterized by frequent short-lasting attacks of pain localized in the orbital, supraorbital and/or temporal area. Deep brain stimulation (DBS) of the ipsilateral posterior hypothalamus has been shown to be effective in patients with chronic refractory cluster headache. We report the results of evaluation of long-term follow-up after chronic DBS.

Method: In three men with severe unilateral cluster headache DBS of the posterior hypothalamus was performed after preoperative evaluation and pain assessment. Electrodes were implanted stereotactically (model 3389, Medtronic, MN, USA) in the ipsilateral posterior hypothalamus with microelectrode guidance. Long-term follow-up was achieved up to 72 months.

Results: In two patients, both intensity and frequency of the attacks were reduced (frequency 80%, intensity 70%) after surgery, whereas in one patient there was no significant change. Long-term evaluation at 72 and 86 months postoperatively in the first two patients showed sustained significant pain reduction (80% of frequency, 70% of pain intensity). The stimulation parameters for deep brain stimulation were: 1,4-4,4 V, 130 Hz, 60µs, bipolar stimulation. However, in one patient CH reoccurred on the other side 86 months after the initial treatment. After detailed assessment a second electrode was implanted in the posterior hypothalamus ipsilateral, resulting in a significant reduction of pain attacks and intensity of 50% postoperatively. In a second patient frontal headache without attacks or vegetative symptoms developed in 2013. MRI scan showed a frontal cortical tumor. The tumor was successfully removed.

Conclusions: DBS in the posterior hypothalamus is an effective therapeutic option for selected patients with chronic refractory cluster headache at long-term follow-up.