NEURALGIA DE ARNOLD
Introduction: The posterior deep temporal artery is a branch of the maxillary artery from which emerges near the origin of the middle meningeal artery. The role of the maxillary artery has never been discussed in migraine, and yet it gives origin to the two most important arteries responsible for the pain during a migraine attack. Objective: The objective of this paper is to show that, contrariwise to what has always been thought, it is not the superficial temporal artery that is responsible for the pain in the temple during a migraine attack, but the posterior deep temporal artery. Methods: A hundred diaries from different patients, each containing the locations of pain during attacks in one whole year, were analyzed. Results: Out of 8,178 locations obtained from the diaries 28.0% were on the temples, more on the left than on the right. Out of the 100 patients 24 underwent a subcutaneous infiltration in the temporal region after the posterior deep temporal artery was localized by means of a Doppler, with absolute success in 12 patients and partial success in five. Conclusions: The posterior deep temporal artery, which is superficial in the temple before it penetrates the temporal muscle, has always been neglected, and yet it is the artery patients point to during a migraine attack, and not to the superficial temporal artery.