The Presence and Role of Zygomatic-temporal Neuroma Triggering Cluster Headache
Condition: Cluster Headache; Craniofacial Pain Syndrome
MeSH terms: Neuroma; Facial Neuralgia; Cluster Headache; Headache; Facial Pain
Study type: Observational

Summary: 
      Role of a neuroma of zygomatic-temporal in triggering of a cluster headache. Exploratory
      diagnosis, resection, and pathological examination of tumor anticipated

      .
    

Detailed description: 
      An anatomical coordinated communication of a Cluster Circuit turned on by Zygomatico-Temporal
      neuroma, a malicious possibly nontraumatic, neoplastic tissue coding and decoding itself upon
      autonomic release of neurotransmitter(s). Exhaustion of neurotransmitter synthesis turns out
      the explosions of pain-symptoms off.

      Poor attention to the characterization of a peripheral neuroma of trigeminal nerve branch
      deranged attention to central(CNS) characterization of Cluster Symptoms.

      This study based on our experimental results of minimal surgical procedure to explore,
      diagnose and resect a Zygomatico-Temporal neuroma in the temple of patients suffering from
      EpisodicChronic, Cluster Headache-ECCH. The goal is to light on this speculation in a novel
      analysis of events to put an end to devastating catastrophic headaches. Detailed anatomical
      components loci of the autonomic symptoms in the cluster headache reveal the presence of an
      electrical neural circuit.

      The extracranial circuit components of ECCH reflects the anatomical nerve components
      participating reflection of the single circumscribed symptom:

        1. Zygomatico-Temporal-neuroma

        2. Zygomatic nerve V-II

        3. Intraorbital communicants rami

        4. Lacrimal nerve V-I

        5. Ophthalmic nerve Intraorbital routing, supraorbital nerves, the upper eyelid, the
           conjunctiva and cornea of the eye, the nose (including the tip of the nose, except alae
           nasi), the nasal mucosa, the frontal sinuses. V-I

        6. Optic nerve via ophthalmic nerve routing and electricity propagation.

        7. Pterygopalatine ganglion as peripheral and CNS coordinator center.

      An intracranial CNS reaction follows in response to the perception of pain materialized in
      neuroimaging during the activity of ECCH.
    

Intervention name(s): Minimal surgical exploration for a neuroma
Intervention type(s): Other
Intervention description(s): Orientation marking of the trigger point by injectable sterile methylene blue dye 0.1ml. Marking a 2-3-centimeter long incision line 7 mm from the Neuroma marking on the skin. Local anesthesia using plain 2% lidocaine infiltration of the circumferential exploratory area. Sterile prep and drape in surgical fashion. Meticulous exploratory preparation of the subcutaneous tissue 20 mm at each side of the incision line. Appropriate visibility of the ZT nerve branches embedded in lipomatous and connective tissue over the temporal fascia. Exploratory visualization of the subcutaneous marked tissue by methylene blue using a binocular magnification eases visualization. Using an Adson tissue forceps with side grasping teeth, now an exploratory touch of the above and distal of the marking would deliver the hypersensitive painful Neuroma tissue for sharp excision using surgical scissors. Control of bleeding and skin closure. Sterile pressure dressing. Specimen be sent to pathologic examination.
Other intervention name(s): Clusterotomy
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        ٠patients suffering from episodic and chronic cluster headaches
      
Keywords: cluster headache; neuralgic headache