The TEMMA journey is a 4-step process. The first two steps are evaluation — confirming that TEMMA is right for you. The last two are the actual procedure and recovery.
Your journey begins with a visit to a migraine-trained neurointerventional specialist.
During this visit, your specialist will review your migraine history in detail — including what treatments you have tried, what has helped, what has not, and how migraines affect your daily life. We will examine your prior imaging (MRI or CT of the brain, if available) and discuss whether the anatomy of your middle meningeal artery and dura makes TEMMA a reasonable option for you.
This is a short procedure that helps predict whether TEMMA will work for you.
The lidocaine test is essentially a small, short version of the TEMMA procedure, designed to test whether numbing the MMA pathway reduces your migraine pain. A tiny numbing injection is placed at the wrist or groin (similar to the access point used for many heart procedures). A thin catheter is guided through your blood vessels into the MMA using live X-ray imaging. A small amount of lidocaine — a common numbing medicine — is injected directly into the artery. You will be awake and able to tell us whether your migraine pain significantly improves over the next several days to weeks. If it does, there is a very strong chance you will benefit from the full TEMMA procedure.
If the lidocaine test is positive, we move forward with the actual treatment.
The TEMMA procedure is performed using a technique that has been used safely in neurovascular care for over 40 years. You receive local anesthesia at the access site and light sedation to keep you comfortable. A 2–3 mm opening is made at the wrist or groin. A microcatheter is navigated through your blood vessels up into the middle meningeal artery, using live X-ray imaging. A soft platinum coil — about the size of a small spring — is then placed into the artery. The coil gently seals the artery, reducing the abnormal dural blood flow that contributes to your migraines. Because the MMA does not supply brain tissue, sealing it is considered safe and well tolerated.
Recovery after TEMMA is typically quick and uncomplicated.
Immediately after the procedure, you will rest for 1–2 hours while the sedation wears off. A small bandage is placed at the wrist or groin access site. Most patients go home the same day with simple instructions — including when to resume normal activities and what to watch for. Most patients experience only mild soreness at the access site, temporary scalp sensations, and gradual improvement in their migraine activity over the days and weeks that follow.
Schedule a consultation. We'll review your history, explain the procedure, and answer every question.