Guyuron Bahman, Riazi Hooman, Long Tobias, Wirtz Emily
Cleveland, Ohio From the Department of Plastic Surgery, Case Western Reserve University.
Plast Reconstr Surg. 2015 Apr;135(4):1109-1112. doi: 10.1097/PRS.0000000000001102.
The senior author (B.G.) has been able to use the Doppler as a tool for identifying the site of irritation of a nerve by an adjacent artery in different migraine trigger sites. The purpose of this study was to assess the correlation between the most intense pain site identified by the patients, presence of Doppler signal, and the intraoperative finding of an artery in the target site.
This was a retrospective review of the charts of patients who underwent surgical treatment of migraine headaches involving the auriculotemporal nerve. The target area was identified by asking patients to point to the most intense headache site and most tender area at the time of examination using the index finger tip. This site was marked and Doppler was used to identify the vascular signal. Doppler examination results, intraoperative presence of the superficial temporal artery or its branches, and the involved nerve were recorded and tabulated.
A positive Doppler signal over the area of most intense temporal pain, identified by the patient preoperatively, correlated with intraoperative presence of the artery in 100 percent of the patients. Doppler signal was noted on 34 sites and arterectomy was carried out in all 34 sites.
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.
资深作者（B.G.）已能够将多普勒作为一种工具，用于识别不同偏头痛触发部位中相邻动脉对神经的刺激部位。本研究的目的是评估患者确定的最强烈疼痛部位、多普勒信号的存在与目标部位动脉的术中发现之间的相关性。
这是一项对接受涉及耳颞神经偏头痛手术治疗患者病历的回顾性研究。通过让患者在检查时用食指尖指出最强烈的头痛部位和最 tender 区域来确定目标区域。标记该部位，并使用多普勒识别血管信号。记录并整理多普勒检查结果、术中颞浅动脉或其分支的存在情况以及受累神经。
术前患者确定的最强烈颞部疼痛区域出现的阳性多普勒信号与100%的患者术中动脉的存在相关。在34个部位检测到多普勒信号，并在所有34个部位进行了动脉切除术。
最强烈疼痛部位的多普勒信号可以预测性地记录最疼痛部位动脉的存在，并导致精确确定血管对神经的刺激位置，以及成功切除肇事动脉。
