Modern migraine research has converged on a remarkable insight: many of the headaches we call migraine may originate in a thin, pain-sensitive layer of tissue that sits between the skull and the brain — the dura — and specifically in the blood vessels that supply it.
The middle meningeal artery (MMA) is the main blood vessel that supplies the dura. When this system becomes overactive — through inflammation, vasodilation, or other mechanisms — it can activate the pain-sensing nerves in the dura and trigger a migraine attack.
This “MMA–dura pathway” is now considered one of the central mechanisms of migraine — and is exactly what TEMMA is designed to address.
The outermost of three membranes that surround the brain and spinal cord. The dura is tough and fibrous, but also densely innervated with pain-sensing nerve fibers — making it one of the most pain-sensitive tissues in the head.
A branch of the maxillary artery that runs along the inside of the skull and supplies most of the dura. It does NOT supply the brain itself — a critical point that makes procedures on this vessel safe.
The network of pain-sensing nerves (primarily from the trigeminal nerve) that innervate the dura and its blood vessels. When activated, these nerves release inflammatory molecules that drive migraine pain.
Calcitonin gene-related peptide (CGRP) is a key signaling molecule in migraine. It is released from trigeminal nerve endings during an attack and causes vasodilation and inflammation. CGRP inhibitors are a major class of modern migraine drugs.
Here's the key insight: most of the medications that work for migraine — including the newest CGRP inhibitors, triptans, and NSAIDs — all act, at least in part, on this same dural vasculature.
They reduce the abnormal signaling in the dural blood vessels, decrease inflammation, and prevent the pain cascade from amplifying. But they only work while the medication is active in your system.
TEMMA takes the same idea one step further: instead of repeatedly dosing a medication to reduce dural signaling, we gently seal the main blood vessel that supplies the dura on one side. This provides a long-lasting reduction in the abnormal signals — without the need for ongoing medication.
Think of it as a one-time, durable version of what migraine medications do temporarily.
The 4-step procedure uses the MMA–dura pathway as its target — safely and durably.
See the 4 Steps