Child's Nervous System

, Volume 35, Issue 12, pp 2385–2389 | Cite as

Long-term efficacy of superficial temporal artery ligation and auriculotemporal nerve transection for temporal cluster headache in adolescent

  • Bowen Chang
  • Wanchun Zhu
  • Jin Zhu
  • Shiting LiEmail author
Original Article



Cluster headache is a primary headache disorder, which has affected up to 0.1% population. Superficial temporal artery ligation combined with auriculotemporal nerve transection (SLAT) is one of the surgical alternatives to treat the drug-resistant temporal cluster headache (TCH). The current work aimed to assess the effect of SLAT on TCH patients based on the very long-term clinical follow-up.


The current retrospective study had enrolled 20 adolescent TCH patients undergoing SLAT between December 2016 and January 2018. The headache diaries as well as the pain severity questionnaire of the visual analog scale (VAS) had been collected to measure the pain severity before and after surgery.


The pain-free rates 3 days, as well as 1, 6, and 12 months, after SLAT surgery were 2.00%, 10.00%, 25.00%, and 70.00%, respectively. The frequency of TCH attack daily was found to be markedly reduced on the whole; besides, the pain degree was also remarkably decreased.


Results in this study indicate that the sustained headache can be relieved after SLAT in adolescent patients with intractable TCH.


Cluster headache Superficial temporal artery Auriculotemporal nerve Headache Adolescent 



The authors would like to thank all the individuals who offered help and advice on this study.

Compliance with ethical standards

The study protocol was approved by the Institutional Ethics Committee of the Xinhua hospital.

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.


  1. 1.
    Ljubisavljevic S, Trajkovic JZ (2018) Cluster headache: pathophysiology, diagnosis and treatment. J NeurolGoogle Scholar
  2. 2.
    Goadsby P, Wei D-T, Yuan Ong J (2018) Cluster headache: epidemiology, pathophysiology, clinical features, and diagnosis. Ann Indian Acad Neurol 21:3–8CrossRefGoogle Scholar
  3. 3.
    Liu SC, Kao MC, Huang YC, Su WF (2018) Vidian Neurectomy for management of chronic cluster headache. Neurosurgery. 0:1–6Google Scholar
  4. 4.
    Sohn J-H, Choi Y-J, Kim B-K, Chung P-W, Lee MJ, Chu MK, Ahn J-Y, Kim B-S, Song T-J, Oh K, Lee K-S, Kim S-K, Park K-Y, Chung JM, Moon H-S, Chung C-S, Cho S-J, Park J-W (2018) Clinical features of probable cluster headache: a prospective, cross-sectional multicenter study. Front Neurol 9:1–7CrossRefGoogle Scholar
  5. 5.
    Aschehoug I, Bratbak DF, Tronvik EA (2018) Long-term outcome of patients with intractable chronic cluster headache treated with injection of Onabotulinum toxin a toward the sphenopalatine ganglion - an observational study. Headache. 00:1–18Google Scholar
  6. 6.
    Ekbom K, Monstad I, Prusinski A, Cole JA, Pilgrim AJ, Noronha D (1993) Subcutaneous sumatriptan in the acute treatment of cluster headache: a dose comparison study. Acta Neurol Scand 88:63–69CrossRefGoogle Scholar
  7. 7.
    Choong CK, Ford JH, Nyhuis AW, Joshi SG, Robinson RL, Aurora SK, Martinez JM (2017) Clinical characteristics and treatment patterns among patients diagnosed with cluster headache in U.S. healthcare claims data. Headache. 57(9):1359–1374CrossRefGoogle Scholar
  8. 8.
    Buture A, Boland JW, Dikomitis L, Ahmed F (2019) Update on the pathophysiology of cluster headache: imaging and neuropeptide studies. J Pain Res 12:269–281CrossRefGoogle Scholar
  9. 9.
    Mitsikostas DD, Ashina M, Craven A, Diener HC, Goadsby PJ, Ferrari MD, Lampl C, Paemeleire K, Pascual J, Siva A, Olesen J, Osipova V, Martelletti P (2016) European headache federation consensus on technical investigation for primary headache disorders. J Headache Pain 17:1–8Google Scholar
  10. 10.
    Miller S, Watkins L, Matharu M (2017) Treatment of intractable chronic cluster headache by occipital nerve stimulation: a cohort of 51 patients. Eur J Neurol 24:381–390CrossRefGoogle Scholar
  11. 11.
    Fontaine D, Santucci S, Lanteri-Minet M (2018) Managing cluster headache with sphenopalatine ganglion stimulation: a review. J Pain Res 11:375–381CrossRefGoogle Scholar
  12. 12.
    Binfalah M, Alghawi E, Shosha E, Alhilly A, Bakhiet M (2018) Sphenopalatine ganglion block for the treatment of acute migraine headache. Pain Res Treat 2018:1–6CrossRefGoogle Scholar
  13. 13.
    Zagami AS (2018) Treatment of the patient with refractory headache. Curr Pain Headache Rep 22:23CrossRefGoogle Scholar
  14. 14.
    Seijo-Fernandez F, Saiz A, Santamarta E, Nader L, Antonio M, Alvarez-Vega, Lozano B, Seijo E, Barcia JA (2018) Long-term results of deep brain stimulation of the Mamillotegmental fasciculus in chronic cluster headache. Stereotact Funct Neurosurg 96:215–222CrossRefGoogle Scholar
  15. 15.
    Kumar S, Kalita J, Misra UK (2019) Repetitive transcranial magnetic stimulation in cluster headache. Brain Stimul 12:383–384CrossRefGoogle Scholar
  16. 16.
    Goadsby PJ (2002) Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Lancet Neurol 1(4):251–257CrossRefGoogle Scholar
  17. 17.
    May A (2005) Cluster headache: pathogenesis, diagnosis, and management. Lancet. 366:843–855CrossRefGoogle Scholar
  18. 18.
    Frese A, Evers S, May A (2003) Autonomic activation in experimental trigeminal pain. Cephalalgia 23:67–68CrossRefGoogle Scholar
  19. 19.
    Bertozzi N, Simonacci F, Lago GL, Bordin C, Raposio E (2018) Surgical therapy of temporal triggered migraine headache. Plast Reconstr Surg Glob Open 12:1980CrossRefGoogle Scholar
  20. 20.
    McGeeney BE (2018) Cluster headache and other trigeminal autonomic Cephalalgias. Semin Neurol 6:603–607Google Scholar
  21. 21.
    Guyuron B, Riazi H, Long T, Wirtz E (2015) Use of a Doppler signal to confirm migraine headache trigger sites. Plast Reconstr Surg 135:1109–1112CrossRefGoogle Scholar
  22. 22.
    Peled ZM (2016) A novel surgical approach to chronic temporal headaches. Plast Reconstr Surg 137:1597–1600CrossRefGoogle Scholar
  23. 23.
    Levin M (2010) Nerve blocks in the treatment of headache. Neurotherapeutics. 7:197–203CrossRefGoogle Scholar
  24. 24.
    Janis JE, Hatef DA, Ivica Ducic MD, Ahmad J, Wong C, Ronald E, Hoxworth TO (2010) Anatomy of the auriculotemporal nerve: variations in its relationship to the superficial temporal artery and implications for the treatment of migraine headaches. Plast Reconstr Surg 125:1422–1428CrossRefGoogle Scholar
  25. 25.
    Totonchi A, Pashmini N, Guyuron B (2005) The zygomaticotemporal branch of the trigeminal nerve: an anatomical study. Plast Reconstr Surg 115:273–277PubMedGoogle Scholar
  26. 26.
    Schmidt BL, Pogrel MA, Necoechea M, Kearns G (1998) The distribution of the auriculotemporal nerve around the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:165–168CrossRefGoogle Scholar
  27. 27.
    Komarnitki I, Andrzejczak-Sobocińska A, Tomczyk J, Deszczyńska K, Ciszek B (2012) Clinical anatomy of the auriculotemporal nerve in the area of the infratemporal fossa. Folia Morphol (Warsz) 71:187–193Google Scholar
  28. 28.
    Iwanaga J, Watanabe K, Saga T, Fisahn C, Oskouian RJ, Tubbs RS (2017) Anatomical study of the superficial temporal branches of the auriculotemporal nerve: application to surgery and other invasive treatments to the temporal region. J Plast Reconstr Aesthet Surg 70:370–374CrossRefGoogle Scholar
  29. 29.
    Rozen TD (2019) High-volume anesthetic suboccipital nerve blocks for treatment refractory chronic cluster headache with Long- term efficacy data: an observational case series study. Headache. 59:56–62CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurosurgery, XinHua Hospital, School of MedicineShanghai Jiaotong UniversityShanghaiChina

Personalised recommendations