Use of a Doppler Signal to Confirm Migraine Headache Trigger Sites

Abstract

Doppler signal in the site of most intense pain can predictably document the presence of an artery in the most painful site and lead to precise location of the nerve irritation by a vessel and successful removal of the offending artery.

Emergence of Secondary Trigger Sites after Primary Migraine Surgery

“…More recently, the senior author has found that a handheld Doppler probe will almost invariably locate an arterial signal near a residual or new pain site, indicating a close association with vascular irritation. 31 These minor trigger sites then are deactivated under local anesthesia by removing the offending vessel and the fascia bands, if present. This strategy has helped to further target small peripheral sites and produce higher elimination rates.…”

Anatomical Regional Targeted (ART) BOTOX Injection Technique: A Novel Paradigm for Migraines and Chronic Headaches

“…Point tenderness here should not be confused with temporomandibular joint pain, which requires a different treatment. While recently described 36,37 to confirm site 5A compression by the artery, we do not routinely use Doppler to find this point when we inject BOTOX. Although the use of Doppler can be very helpful for intraoperative localization of the artery and academic exercises, we feel that the added injection time with an often apprehensive migraine patient adds no value to the routine use of Doppler.…”

Decompression–Avulsion of the Auriculotemporal Nerve for Treatment of Migraines and Chronic Headaches

“…These patients may complain of more superior pain localized in the temple as opposed to diffuse low temporal pain closer to the lateral canthus (site II). In addition, one can perform a Doppler scan of the area and confirm the artery/nerve compression point preoperatively as described by Guyuron et al 15 We find the intraoperative use of Doppler to be particularly helpful. The direct approach for site V has been used with no clear description in the literature of the specific technique yielding the safest and most efficient ATN decompression, commonly performed in conjunction with ZTBTN decompression.…”