Headache following intracranial neuroendovascular procedures

Headache: The Journal of Head and Face Pain, 04/27/2012

Occurrence of post–procedure headache (PPH) was common after intracranial endovascular procedures (IEPs) and especially so with coiling and in women, smokers, and those with anxiety/depression, and was often of longer duration than allowed by current International Classification of Headache Disorders–II criteria. The yield of diagnostic testing was low, and in a small subgroup treatment with triptans or DHE did not cause adverse events in pre/post–coiled aneurysms. Prospective studies are needed to confirm these findings.

Methods

  • Authors conducted a retrospective chart review of adult patients undergoing IEPs.
  • Bivariate analyses were conducted to compare patients who did and did not develop PPH.

Results

  • Authors reviewed records pertaining to 372 patients, of whom 263 underwent intracranial coil embolizations, 21 acrylic glue embolizations, and 88 stent placements.
  • PPH occurred in 72% of coil patients, 33% of glue patients, and 14% of stent patients.
  • Significant risk factors for post–coil HA were female gender, any pre–coil HA history, smoking, and anxiety/depression.
  • A pre–stent history of HA exceeding 1 year's duration, and smoking were risk factors for post–stent HA.
  • A pre–glue history of HA exceeding 1 year was the only risk factor for post–glue HA.
  • In the small subgroup available for study, treatment with triptans or DHE was not associated with adverse events in pre/post–coiled aneurysms.
  • Diagnostic testing was low yield.

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