25 patients (2 men, 23 women, median age =45 years, range 25-67 years) participated. Fifteen/25 patients reported side-locked headaches; 19/25 reported chronic daily headaches. The most common area of pain was at the skull base (11/25). Others symptoms included: cognitive problems (16/25), visual blurring (11/25), chest pain (11/25), vertigo (10/25), mid-scapular pain (10/25), ear pressure (9/25), tinnitus (8/25), sinus pressure (7/25), hemifacial spasms (6/25), syncope (5/25), and facial flushing (4/25). Interventions included unilateral or bilateral 1st rib removal (16/25), scalenectomies (6/25), venoplasties (9/25), pectoralis minor tendon releases (3/25), and vein patches (3/25). Resolution of headache days ranged from 100% (4/13), 75% (2/13), 25-50% (2/13), and 0% (5/13) after rib resection (13/16 reported). Other therapies improved headaches in 2/8 (75% and 100% each, 0% in 6/8). 4 patients did not make a report on headache response. Medication use reduction included: 4/5 on narcotics, 5/5 on butalbital, 6/9 on triptans, 9/17 on anti-inflammatories, 5/9 on combination analgesics. One patient who had multiple surgeries in the interim increased narcotic use. On a 5-point Likert scale of strongly agree (2) to strongly disagree (-2), the change for “I am fully functional at work," was all towards agree (range 0-4, mean 1.22+/-1.48); similarly, “I am fully functional at home.” (range 0-3, mean 1.17+/-1.34).