Nerve decompression surgery relieves young artist’s debilitating migraines after COVID, helping her reclaim her life and creativity
Audrey Maynard remembers her junior year of high school in fragments.
For seven months, after a mild case of COVID, she lived with an unbroken migraine so severe that light and noise became hard to tolerate, and even standing was difficult. A student at the Governor’s School for the Arts, she couldn’t attend class regularly. She gradually lost the ability to do what had always grounded her – drawing and painting.
Due to her chronic pain, Audrey also struggled to eat. She developed gastritis and lost 30 pounds, requiring a special device called an NG tube that went from her nose directly to her stomach to deliver extra nutrition.
Desperate for help, Audrey visited pediatric neurologist, Dr. Ryan Williams, a headache specialist and medical director of the Headache Center at CHKD. Under his care, Audrey tried various methods to control her head pain – from bed rest to medications. “I was just miserable,” she says. “And the migraines did not stop.”
Dr. Williams then tried nerve blocks around her eyebrows and other areas of her head. Remarkably, the pain vanished. Audrey cried with relief.
“It was amazing,” Audrey says. “It was like a switch flipped, I was back, and I was pain-free.”
For the first time in months, Audrey felt like herself again. She rushed home and painted for hours, channeling months of agony into a single piece of art.
“It’s still one of my favorite pieces,” she says.
Unfortunately, Audrey’s relief didn’t last. She soon needed more nerve blocks, but each one seemed to wear off more quickly than the last. That’s when Dr. Williams referred her to Dr. Yifan Guo, a plastic surgeon at CHKD, to consider nerve decompression surgery, an option that could possibly provide longer-lasting migraine relief.
“This kind of surgery can be very helpful for a small percentage of patients,” Dr. Williams says.
Before Dr. Guo joined CHKD in 2021, Dr. Williams had to refer patients outside Virginia for surgical consultations on nerve decompression. “There are not very many surgeons who do what Dr. Guo does.”
When Audrey first met Dr. Guo, her severe migraines were back. Dr. Guo began by asking Audrey exactly where she felt the pain, then used nerve blocks in a few targeted areas to pinpoint which nerves might be involved. He checked if the pain went away after each block. If it did, Audrey would go home and wait for her migraine to return. Then, Dr. Guo repeated the nerve block to confirm that the same nerves were responsible.
“The nerve block is both diagnostic and therapeutic,” says Dr. Guo. “If the nerve block works, that’s telling me it’s a peripheral nerve problem.”
After a few appointments to verify that the nerve blocks were consistently successful, he determined that Audrey would need two surgeries. The first procedure would focus on the nerve behind her eyes, which was causing her the most pain. He would access the nerve by going through the crease in her eyelids. The second surgery would address the nerve at the base of her skull.
During each procedure, Dr. Guo cauterized blood vessels pressing on the nerve and released any muscle or fascia causing constriction.
It wasn’t long after the first surgery that Audrey began to feel some relief.
“Once the swelling went down, I was able to get on with my life again,” Audrey says. “And after a couple of weeks, I felt amazing. I was no longer in any pain. You can’t even see the scars. Dr. Guo did a wonderful job.”
Today, Audrey remains pain-free and deeply grateful for the care she received at CHKD. With her appetite restored and the migraines gone, she has been able to gain some weight back. She is studying business management at Christopher Newport University and once again spends her free time painting and drawing – activities that seemed impossible during the worst months of her illness.
“My surgeries with Dr. Guo changed my whole life. I never thought they would work so well,” she says. “I haven’t had a migraine since.”
Published in CHKD’s KidStuff Magazine, Summer 2026
Written by Alice Warchol • PHOTOGRAPHY by Ken Mountain
