{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:24:27Z","timestamp":1790011467163,"version":"4.0.1"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Prior case reports have suggested that treating thoracic outlet syndrome (TOS) may relieve intractable migraine headaches, but there has been no case series large enough to show when underlying TOS should be suspected as a contributor to migraine burden. This observational followed by questionnaire study was performed in an outpatient neurology practice to identify clinical features of patients with migraine in which TOS contributed to migraine burden. We report the clinical features of 50 consecutive patients (48 women, 2 men, age\u2009=\u200943.9+\/12.7\u2009years) who were treated for chronic migraine and TOS (20 migraine with aura, 28 migraine without aura, two hemiplegic migraines). Headaches had become chronic within 1\u2009year of onset in 21 patients (42%) with characteristics as follows (percentages are based on known data): greater severity ipsilateral to TOS limb pain (38\/50=76%), presence of limb swelling (32\/48=67%), and worsened by recumbency (32\/38=84%). Thirty\u2010two patients eventually needed surgery, which included percutaneous transluminal venoplasty, 1st rib removal, scalenectomy, pectoralis minor tenotomy, and\/or vein patching. The mean improvement of headaches on the treated side was 72\u2009\u00b1\u200926.7%; 12 patients experienced complete resolution of headaches after treatment of TOS (follow\u2010up 7.2\u2009\u00b1\u20095.2\u2009months). Questionnaire responders reported significant reductions in headache days (18.3\u2009\u00b1\u20098.6 to 11.1\u2009\u00b1\u200910.8\u2009days\/month, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0016), severity (7.8+\/2.5 to 5.4\u2009\u00b1\u20092.9, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.00079), and need for emergency care (3.6\u2009\u00b1\u20094.0 to 0.71\u2009\u00b1\u20091.3 visits\/year, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0029). Chronic migraines can be important manifestations of TOS. Early transition to a chronic state, lateralized limb pain, and headaches worsened by recumbency are clues to the contribution of TOS pathology. Addressing the TOS contribution to migraine can significantly reduce migraine headache burden.<\/jats:p>","DOI":"10.1002\/ca.24242","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T06:26:19Z","timestamp":1731651979000},"page":"314-323","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Treatment of thoracic outlet syndrome to relieve chronic migraine"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3804-0879","authenticated-orcid":false,"given":"YH","family":"Cha","sequence":"first","affiliation":[{"name":"Department of Neurology University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Randall","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Weber","sequence":"additional","affiliation":[{"name":"St. Francis Medical Center  Tulsa Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ahn","sequence":"additional","affiliation":[{"name":"Texas Christian University School of Medicine  Fort Worth Texas USA"},{"name":"Dallas Fort Worth Vascular Surgery  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.02.234"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2013.12.009"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-65377-0.00012-X"},{"key":"e_1_2_10_5_1","first-page":"99","article-title":"Variation of the veins of the head and neck\u2010external jugular and facial vein","volume":"5","author":"Balachandra N.","year":"2012","journal-title":"International Journal of Anatomical Variations"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.10.004"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.05.109"},{"issue":"4","key":"e_1_2_10_8_1","first-page":"298","article-title":"Scheuermann's disease as a model displaying the mechanism of venous obstruction in thoracic outlet syndrome and migraine patients: MRI and MRA","volume":"95","author":"Collins J. 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