Could Temporal Pulsations Be A Cause Of My Migraines?
Q: Dr. Eppley, have you ever treated sufferers of migraines caused by (likely) the hard throbbing of the superficial temporal artery. My wife has 5 migraines a week, nearly all of which are in this area. We do not understand the root cause of the pulsations themselves, but it is possible these hard pulsations (lasting hours, or even days on end) are irritating the nerves local to the artery, and becoming interpreted as migraine in the brain. Given that medications (and neurologists and others) offer no relief, and she has suffered for decades, we are exploring procedures. Thank you.
A: While getting to the origin or even finding an effective treatment for migraines is never simple, the simple answer to your question is yes. It is very possible that high flow through the superficial temporal artery (STA) can be a source of migraines. While I would have initially thought it was possible but with a low probability, I recently treated a lady with a 30 year history of refractory migraines of the right temporal region with 2-point ligation of the STA with a dramatic and sustained reduction of her migraines. She felt that the pulsations she was feeling was a major contributor to her migraines and the origins was clearly on the temporal side with very visible pulsations. Given that there is no risk of any downside to STA ligation and it is a minor procedure with no recovery, it seemed like a reasonable thing to do.
While there would be no guarantee that STA ligationswould be effective for your wife’s migraines, and they should always be done from two points to eliminate recurrent pulsations due to retrograde flow, it would be relatively easy to eliminate this potential source.
Dr. Barry Eppley