Surgery for treatment of refractory chronic cluster headache: toward standard procedures

The degree of disability due to chronic cluster headache refractory to conservative treatments justifies surgical procedures as second-line treatments. Many studies and reports nowadays confirm the efficacy of the two mostly used surgical techniques in such cases. Both deep brain stimulation and occipital nerve stimulation are in fact currently utilized for this purpose but the surgical technique has not yet been standardized. We describe the surgical steps of both procedures.