A New Technique Employing Direct Tactile Pressure on the common Carotid Artery to Relieve Acute Episode Attack of Migraine Headache: A Single-Arm Interventional Study

Migraine, is a common neurological disorder, and its pathology and acute treatment has not been determined so far. In the contemporary literature, there is no remedy that can abort an acute episode of migraine. 

We aimed to evaluate the effect of transient presser on the middle part of common carotid artery for terminating an acute attack of migraine headache. 

It is an interventional study without a control limb, performed on patients within age range of 18-45 years. Patients with established migraine headache based on International Classification of Headache Disorders (ICHD) guidelines, who had no atheromatous plaque in their common carotid arteries were included. Pain intensity was evaluated by Universal Pain Assessment Tools (UPAT). In safe position, applying vital signs monitoring and ipsilateral of headache, a gentle pressure was applied on the common carotid artery, lateral to the cricothyroid membrane and medial border of the Sterno-Cleido-Mastoid (SCM) muscle, by using both index and middle fingers, till the headache was relieved, following which the pressure was maintained for a period of 15 seconds. Then the middle finger was maintained at its position and the index finger slid caudally with the same pressure as far a distance of four centimeters and the pressure withdrawn slowly. After 2 minutes, patients were asked to report any change in headache which was recorded. 

Totally, 215 patients entered this study. The mean of pain score before and after using the technique regarding to UPAT, was 6.28±1.34 and 0.4±0.64, respectively; Also, the pain decreases equal 5.88 score was significant, special by according sex (p<0.001). No side effect was seen. 

It seems that pressure on the common carotid artery and extending the pressure caudally, helped a rapid, safe and significant reduction in pain score for patients with acute attack of migraine headache.