Headache and Treatment of Unruptured Intracranial Aneurysms

Julieta E. Arena, Maximiliano A. Hawkes, Mauricio F. Farez, Lucia Pertierra, Alejandro A. Kohler, Mariano Marrodán, Darío Benito, Maria T. Goicochea, Juan C. Miranda, Sebastián F. Ameriso

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background and Purpose The relationship between unruptured intracranial aneurysms (UIAs) and chronic headache and the impact of aneurysm treatment on headache outcome are controversial. The aim of this study was to determine clinical features of a supposedly primary headache in patients with UIA. We also assessed changes in headache characteristics after UIA treatment. Methods We examined clinical and imaging data of patients in whom a UIA was diagnosed during diagnostic workup of a suspected primary headache. Medical records were reviewed and personal telephone follow-ups were performed after UIA treatment to assess changes in the frequency and intensity of the headache. Results Forty-two patients (76%) reported a substantial improvement in headache frequency and intensity after UIA treatment. Forty-five patients (81%) reported a decrease in headache frequency from a median of 8 days/month before treatment to 1 day/month after treatment (95% confidence interval [CI] 81-83, P < .001). The average intensity in an analog pain scale was 7.7 ± 1.6 before treatment and 5.6 ± 2.4 after treatment (P < .001). Higher headache frequency was associated with a greater odd of improvement after treatment (odds ratio 1.12, 95% CI 1.0-1.26, P = .03). No associations were found between the type of headache, type of treatment (endovascular versus surgical), number, size, or localization of the aneurysms and the response to treatment. Conclusions The treatment of UIA had a robust beneficial effect on previous headache. Although a “placebo” effect of aneurysm treatment cannot be ruled out, these results suggest a potential association between UIA and certain chronic headaches usually considered to be primary.

Original languageEnglish (US)
Pages (from-to)1098-1103
Number of pages6
JournalJournal of Stroke and Cerebrovascular Diseases
Volume26
Issue number5
DOIs
StatePublished - May 2017
Externally publishedYes

Keywords

  • Headache
  • endovascular therapy
  • intracranial aneurysm
  • therapeutics

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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