Migraine Surgery
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Migraine Surgery
Migraine surgery is a surgical operation undertaken with the goal of reducing or preventing migraines. Migraine surgery most often refers to surgical decompression of one or several nerves in the head and neck which have been shown to trigger migraine symptoms in many migraine sufferers. Following the development of nerve decompression techniques for the relief of migraine pain in the year 2000, these procedures have been extensively studied and shown to be effective in appropriate candidates. The nerves that are most often addressed in migraine surgery are found outside of the skull, in the face and neck, and include the supra-orbital and supra-trochlear nerves in the forehead, the zygomaticotemporal nerve and auriculotemporal nerves in the temple region, and the greater occipital, lesser occipital, and third occipital nerves in the back of the neck. Nerve impingement in the nasal cavity has additionally been shown to be a trigger of migraine symptoms. Indications and patie ...
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Surgery Operation
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas. The act of performing surgery may be called a surgical procedure, operation, or simply "surgery". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The person or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and a surgeon's assistant is a person who practices surgical assistance. A surgical team is made up of the surgeon, the surgeon's assistant, an anaesthetist, a circulating nurse and a surgical technologist. Surgery usually spa ...
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Supraorbital Artery
The supraorbital artery is a branch of the ophthalmic artery. It passes anteriorly within the orbit to exit the orbit through the supraorbital foramen or notch alongside the supraorbital nerve, splitting into two terminal branches which go on to form anastomoses with arteries of the head. Structure Origin The supraorbital artery arises from the ophthalmic artery. Course and relations It travels anteriorly in the orbit by passing superior to the eye and medial to the superior rectus and levator palpebrae superioris. It then joins the supraorbital nerve to jointly pass between the periosteum of the roof of the orbit and the levator palpebrae superioris towards the supraorbital foramen or notch. After passing through the supraorbital foramen or notch, it often splits into a superficial branch and a deep branch. Distribution The supraorbital artery contributes arterial supply to: the superior rectus muscle, superior oblique muscle, levator palpebrae muscles, periorbita, t ...
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Nasal Concha
In anatomy, a nasal concha (), plural conchae (), also called a nasal turbinate or turbinal, is a long, narrow, curled shelf of bone that protrudes into the breathing passage of the nose in humans and various animals. The conchae are shaped like an elongated seashell, which gave them their name (Latin ''concha'' from Greek ''κόγχη''). A concha is any of the scrolled spongy bones of the nasal passages in vertebrates.''Anatomy of the Human Body''
Gray, Henry (1918) The Nasal Cavity.
In humans, the conchae divide the nasal airway into four groove-like air passages, and are responsible for forcing inhaled air to flow in a steady, regular pattern around the largest possible surface area of
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Nasal Septum
The nasal septum () separates the left and right airways of the nasal cavity, dividing the two nostrils. It is depressed by the depressor septi nasi muscle. Structure The fleshy external end of the nasal septum is called the columella or columella nasi, and is made up of cartilage and soft tissue. The nasal septum contains bone and hyaline cartilage. It is normally about 2 mm thick. The nasal septum is composed of four structures: * Perpendicular plate of ethmoid bone * Vomer bone * Septal nasal cartilage * Maxillary bone (the crest) The lowest part of the septum is a narrow strip of bone that projects from the maxilla and the palatine bones, and is the length of the septum. This strip of bone is called the maxillary crest; it articulates in front with the septal nasal cartilage, and at the back with the vomer. The maxillary crest is described in the anatomy of the nasal septum as having a maxillary component and a palatine component. Development At an early perio ...
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Sternocleidomastoid Muscle
The sternocleidomastoid muscle is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The sternocleidomastoid is innervated by the accessory nerve. Etymology and location It is given the name ''sternocleidomastoid'' because it originates at the manubrium of the sternum (''sterno-'') and the clavicle (''cleido-'') and has an insertion at the mastoid process of the temporal bone of the skull. Structure The sternocleidomastoid muscle originates from two locations: the manubrium of the sternum and the clavicle. It travels obliquely across the side of the neck and inserts at the mastoid process of the temporal bone of the skull by a thin aponeurosis. The sternocleidomastoid is thick and narrow at its centre, and broader and thinner at either end. The sternal head is a round fasciculus, tendinous in front, fleshy behind, arising from the upper part of the front of the manubri ...
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Lesser Occipital Nerve
The lesser occipital nerve or small occipital nerve is a cutaneous spinal nerve. It arises from second cervical (spinal) nerve (along with the greater occipital nerve). It innervates the scalp in the lateral area of the head posterior to the ear. Structure The lesser occipital nerve is one of the four cutaneous branches of the cervical plexus. Origin It arises from the (lateral branch of the ventral ramus) of cervical spinal nerve C2; it may also receive fibres from cervical spinal nerve C3. It originates between the atlas, and axis. Course and relations It curves around the accessory nerve (CN XI) to come to course anterior to it. It then curves around and ascends along the posterior border of the sternocleidomastoid muscle; rarely, it may pierce the muscle. Near the cranium, it perforates the deep fascia. It is continues upwards along the scalp posterior to the auricle. Distribution The lesser occipital nerve distributes branches to the skin. It gives off an ...
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Occipital Artery
The occipital artery arises from the external carotid artery opposite the facial artery. Its path is below the posterior belly of digastric to the occipital region. This artery supplies blood to the back of the scalp and sternocleidomastoid muscles, and deep muscles in the back and neck. Structure At its origin, it is covered by the posterior belly of the digastricus and the stylohyoideus, and the hypoglossal nerve winds around it from behind forward; higher up, it crosses the internal carotid artery, the internal jugular vein, and the vagus and accessory nerves. It next ascends to the interval between the transverse process of the atlas and the mastoid process of the temporal bone, and passes horizontally backward, grooving the surface of the latter bone, being covered by the sternocleidomastoideus, splenius capitis, longissimus capitis, and digastricus, and resting upon the rectus capitis lateralis, the obliquus superior, and semispinalis capitis. It then changes its cours ...
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Splenius Capitis Muscle
The splenius capitis () () is a broad, straplike muscle in the back of the neck. It pulls on the base of the skull from the vertebrae in the neck and upper thorax. It is involved in movements such as shaking the head. Structure It arises from the lower half of the nuchal ligament, from the spinous process of the seventh cervical vertebra, and from the spinous processes of the upper three or four thoracic vertebrae. The fibers of the muscle are directed upward and laterally and are inserted, under cover of the sternocleidomastoideus, into the mastoid process of the temporal bone, and into the rough surface on the occipital bone just below the lateral third of the superior nuchal line. The splenius capitis is deep to sternocleidomastoideus at the mastoid process, and to the trapezius The trapezius is a large paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spi ...
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Trapezius
The trapezius is a large paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It moves the scapula and supports the arm. The trapezius has three functional parts: an upper (descending) part which supports the weight of the arm; a middle region (transverse), which retracts the scapula; and a lower (ascending) part which medially rotates and depresses the scapula. Name and history The trapezius muscle resembles a trapezium, also known as a trapezoid, or diamond-shaped quadrilateral. The word "spinotrapezius" refers to the human trapezius, although it is not commonly used in modern texts. In other mammals, it refers to a portion of the analogous muscle. Similarly, the term "tri-axle back plate" was historically used to describe the trapezius muscle. Structure The ''superior'' or ''upper'' (or descending) fibers of the trapezius originate from the ...
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Greater Occipital Nerve
The greater occipital nerve is a nerve of the head. It is a spinal nerve, specifically the medial branch of the dorsal primary ramus of cervical spinal nerve 2. It arises from between the first and second cervical vertebrae, ascends, and then passes through the semispinalis muscle. It ascends further to supply the skin along the posterior part of the scalp to the vertex. It supplies sensation the scalp at the top of the head, over the ear and over the parotid glands. Structure The greater occipital nerve is the medial branch of the dorsal primary ramus of cervical spinal nerve 2. It may also involve fibres from cervical spinal nerve 3. It arises from between the first and second cervical vertebrae, along with the lesser occipital nerve. It ascends after emerging from below the suboccipital triangle beneath the obliquus capitis inferior muscle. Just below the superior nuchal ridge, it pierces the fascia. It ascends further to supply the skin along the posterior part of ...
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Occipital Neuralgia
Occipital neuralgia (ON) is a painful condition affecting the posterior head in the distributions of the greater occipital nerve (GON), lesser occipital nerve (LON), third occipital nerve (TON), or a combination of the three. It is paroxysmal, lasting from seconds to minutes, and often consists of lancinating pain that directly results from the pathology of one of these nerves. It is paramount that physicians understand the differential diagnosis for this condition and specific diagnostic criteria. There are multiple treatment modalities, several of which have well-established efficacy in treating this condition. Text was copied from this source, which is available under Creative Commons Attribution 4.0 International License Signs and symptoms Patients presenting with a headache originating at the posterior skull base should be evaluated for ON. This condition typically presents as a paroxysmal, lancinating or stabbing pain lasting from seconds to minutes, and therefore a continuo ...
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Occipital Nerve (other)
Occipital nerve may refer to: * Greater occipital nerve * Lesser occipital nerve * Third occipital nerve While under the Trapezius The trapezius is a large paired trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It moves ...
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