Headache following intracranial neuroendovascular procedures
Headache: The Journal of Head and Face Pain, 04/27/2012
Baron EP et al. – 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.
- 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.