Pressure points test: Clinical migraine history is recorded in detail. Diagnosis of migraine must be confirmed, especially in patients with bilateral pain, to exclude patients whose pain results from high blood pressure. I saw 2 cases have unilateral headaches caused only by high blood pressure (they don’t have regular headaches and only when they have up than 16 unilateral headaches come). With the patient lying down, I identify by touch the location where the superficial temporal artery passes in front of the ear pavilion and above the upper edge of the external auditory duct. I mark the skin at this location as No (1). In this place we can close the artery before it do bifurcation to get the very good results. Continues finger pressure points over the artery in place # 1 lead to complete disappearing of frontal/ocular migraine headaches. For patients suffering from occipital migraine, I find that the pain disappearing totally when I apply continued finger pressure to the location where the occipital artery passes behind the ears laterally at protuberate occipitals external, a distance of about 3-4 cm. place No (3).
Surgical Treatment: 1. Frontal/ ocular migraine headaches: Under local anesthesia, I make a small vertical incision ( 3 - 4 cm) over places No (1), then I ligate the artery in these places, cut of the artery is unnecessary, it is enough to ligate it twice with  2/0 silk thread. 2. Occipital migraine: Under local anesthesia, I make a horizontal incision about ( 6 cm) over place # (3) and I ligate the occipital artery. The technique of surgical operation depends on the migraine headaches location. Headaches located in one side in front/ocular area – STA ligated in place #1.Headaches located in both sides in frontal/ ocular area – STA ligated in place # 1 from both sides.Headaches located in both sides in frontal/ ocular area with spread in the back in one side only – STA must be ligated in place # 1 from both sides and Occipital artery in place # 3 in the side where headaches spread to the back.Headaches located only in one side but in frontal/ ocular and occipital area- STA must be ligated in place # 1, and occipital artery in place # 3 at the same side.Headaches located only in one side in the back of head – occipital artery must be ligated in place # 3 in one side only.Headaches located in both sides in the back of the head with or without spread in the frontal area  – occipital artery must be ligated in place # 3 from both sides. Click here to see photos: http://sultaneh.8m.net/photo3.html
Headaches located in both sides in the back of the head with very strong headaches spread to the frontal area – occipital artery must be ligated in both sides with STA in the place # 1 at the side that have usually much sever headaches than others.Some kinds of frontal headaches that need occipital artery to be ligated even if headaches in back of the head not exist, ( rare cases) – pressure points test in time of migraine attack make us know this cases.- To avoid facial nerve injury skin incision should not exceed dawn the upper rim of external audio duct, and not go forward more than 3 cm from the ears. - If the frontal branch cant be closed in place # 1 due to early bifurcation (we cant go forward to ligate it because of facial nerve), so I do a small incision ( 2 cm), over the location where the frontal branch of the superficial temporal artery passes over the lateral edge of the eyebrow  and I ligate it. - Patient should take an oral antibiotic preventive for one week. - Stitches should be removed after 7 days for place #1, and 8 days for place #3. VIDEO:  http://www.youtube.com/v/3xxQyNveWIY
Results: The pain vanished completely, as did the accompanying symptoms (ocular, digestive, neural, psychological), and the patients were able to stop taking medication they had previously used on a regular basis for many years.