ArticlePlastic and reconstructive surgery2020
Patient Pain Sketches Can Predict Surgical Outcomes in Trigger-Site Deactivation Surgery for Headaches.
Article in Plastic and reconstructive surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- NerveAI- a machine learning algorithm for detection of nerve pain in the head and neck.Scientific reports · 2026Article
- A Systematic Review of Pain Drawings for Perioperative Patient Management.Plastic and reconstructive surgery. Global open · 2026Article
- Comparing Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) and Targeted Approaches for OnabotulinumtoxinA in Chronic Migraine Treatment.Plastic and reconstructive surgery. Global open · 2026Article
- Trapezius fascia reveals mechanosensory capacity and predominance of nociceptive axons in occipital neuralgia.Scientific reports · 2026Article
- Artificial intelligence in migraine: a narrative review on the diagnostic, prognostic, and therapeutic applications.Oxford open neuroscience · 2026Article
- Surgical Outcomes Following Distal Nerve Decompression in Patients With Trigeminal Neuralgia.Plastic and reconstructive surgery. Global open · 2025Article
- Use of Magnetic Resonance Neurography for Sensory Nerve Injuries of the Head and Neck.Plastic and reconstructive surgery. Global open · 2025Article
- Introduction to VSI: Migraine surgery in JPRAS open.JPRAS open · 2024Article
- Article
- Treatment Delay in Patients Undergoing Headache Surgery (Nerve Decompression Surgery).JPRAS open · 2023Article
- Functional outcomes between headache surgery and targeted botox injections: A prospective multicenter pilot study.JPRAS open · 2023Article
- Feasibility of Ultrasound Measurements of Peripheral Sensory Nerves in Head and Neck Area in Healthy Subjects.Plastic and reconstructive surgery. Global open · 2023Article
- Refractory occipital neuralgia treatment with nerve decompression surgery: a case series.Frontiers in neurology · 2023Article
- Single midline incision approach for decompression of greater, lesser and third occipital nerves in migraine surgery.BMC surgery · 2022Article
- RPNI, TMR, and Reset Neurectomy/Relocation Nerve Grafting after Nerve Transection in Headache Surgery.Plastic and reconstructive surgery. Global open · 2022Article
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8 authors.
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Abstract
backgroundPatient selection for headache surgery is an important variable to ensure successful outcomes. In the authors' experience, a valuable method to visualize pain/trigger sites is to ask patients to draw their pain. The authors have found that there are pathognomonic pain patterns for each site, and typically do not operate on patients with atypical pain sketches, as they believe such patients are poor surgical candidates. However, a small subset of these atypical patients undergo surgery based on other strong clinical findings. In this study, the authors attempt to quantify this clinical experience.
methodsPatients were prospectively enrolled and completed pain sketches at screening. One hundred six diagrams were analyzed/categorized by two independent, blinded reviewers as follows: (1) typical (pain over nerve distribution, expected radiation); (2) intermediate (pain over nerve distribution, atypical radiation); or (3) atypical (pain outside of normal nerve distribution, atypical radiation). Preoperative and postoperative Migraine Headache Index was compared between subgroups using unpaired t tests.
resultsMigraine Headache Index improvement was 73 ± 38 percent in the typical group, 78 ± 30 percent in the intermediate group, and 30 ± 40 percent in the atypical group. There was a significant difference in Migraine Headache Index between the typical and atypical groups (p = 0.03) and between the intermediate and atypical groups (p < 0.01). The chance of achieving Migraine Headache Index improvement greater than 30 percent in the atypical group was 20 percent.
conclusionsPatient pain sketches classified as atypical (facial pain, atypical pain point origin, diffuse pain) can predict poor outcomes in headache surgery. As the authors continue to develop patient selection criteria for headache surgery, patient sketches should be considered as an effective, cheap, and simple-to-interpret tool for selecting candidates for surgery.
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