Bilateral Middle Meningeal Artery Lidocaine Infusion for Chronic Debilitating Migraines

Inclusion Criteria: 1. Adults aged 18 to 75 years with a very severe to extremely severe medically refractory Chronic Daily Headache (CDH). 1. Chronic: as defined by the International Headache Society Classification ICHD 3 (\>15 headache days a month for a period of at least 3 months) 2. Medically refractory: defined as failure of ≥3 headache preventative treatments. 3. Severely disabling (Migraine Disability Assessment \[MIDAS\] Tool score of ≥ 21 \[Grade IV\]) 4. Score of 6 (very severe) or 7 (extremely severe) on the Global Assessment of Migraine Severity (GAMS) rating scale. 5. Head pain is at least moderate-to-severe intensity (\>5 on a Visual Analog Scale) in ≥50% of headaches. 2. Diagnosis of CDH for ≥ 12 months before screening based on medical records and/or patient self-report. 3. Headache frequency: minimum 15 monthly headache days (MHD) on average across the 3 months prior to screening 4. Patient reports to their provider intolerance or insufficient response with their current preventive treatment (i.e. insufficient reduction in headache frequency, duration, and severity on a standard treatment on a generally accept therapeutic dose for 6 weeks). 5. On a stable concomitant medication and headache preventive for the 3 months prior to screening During Baseline Period: 1. Must have ≥ 15 MHD based on the patient self-maintained diary data during the baseline period. 2. Must have demonstrated \>75% compliance with diary data for the 28 day duration period, or longer if their baseline period carries on past this point. 3. Must continue to meet eligibility criteria when reassessed at baseline completion visit Exclusion Criteria: 1. Recently started new migraine preventative treatment regimen within the past 3 months. 2. Known allergy or sensitivity to lidocaine. 3. Lidoderm patch (not an exclusion if the Lidoderm patch has been removed for ≥ 3 days before the procedure) 4. Severe allergy/anaphylaxis to iodinated contrast dye. 5. Any intracranial pathology on brain imaging (head CT or MRI within the past 12 months) 6. Chronic subdural hematoma 7. Ischemic stroke or myocardial infarction within 3 months 8. History of renal insufficiency with Cr \> 1.5 within 3 months (will be retested during pre-surgical testing). 9\. History of abnormal ECGs within 3 months, specifically: 1. Prolonged QT syndrome 2. Use of medications that may prolong the QT interval such as: anti-nausea, anti-emetics, etc. 10\. Taking any antiarrhythmic medication (other than a beta b…