Saline pomphus around scalp arteries can block migraine pain
Sirs: In our preceding letter [3], we reported that prolonged compression of scalp arteries can abort a migraine attack. In the attempt to explain the mechanism by which this occurs, we considered the possibility of an inhibitory effect on the periarterial visceral afferent nerve. We took into account the paper by Afridi et al. [1], who performed a single injection of 3 ml of 2 % lidocaine (plus 80 mg methylprednisolone) around the greater occipital nerve (GON) on 101 patients with primary headache, obtaining long-lasting complete or partial response in 26 of 57 injections in 54 migraineurs. However, they reported that only about half of the injections had an anesthetic effect in the area of the GON. We therefore supposed that the positive effect reported was due not to blocking the GON, but possibly to the involvement of the neighboring occipital artery and its periarterial visceral nervous afferents. On this basis, we decided to try a lidocaine injection around the occipital artery in the hope of aborting a migraine attack. A woman, 48 years old, affected with LETTER TO THE EDITORS