ABSTRACT. Headache can be attributed to cranial or cervical vascular disorders including ischemic stroke or transient ischemic attack, nontraumatic intracranial hemorrhage, unruptured vascular malformation, arteritis, carotid-vertebral artery pain, and cerebral venous thrombosis. Here, we present a case report of unruptured saccular aneurysm with migraine. The patient was a previously healthy 32-year-old man with repeated episodes of headache for 6 years. Findings for computed tomography and magnetic resonance imaging of the head were normal. Head magnetic resonance angiography revealed a small, nodule-like protuberance seen in the anterior communicating artery. Based on his clinical features and ancillary examinations, the patient was diagnosed with migraine without aura. The patient subsequently underwent digital subtraction angiography (DSA), which revealed a 2-mm cystic protuberance in the superoposterior anterior communicating artery. The patient underwent stent-assisted coil embolization of the aneurysm. Subsequent DSA results indicated no recurrence of aneurysm and no recurrence of headache was reported after surgical treatment.
ABSTRACT.A retrospective analysis of three cases of clinical manifestations of migraine-like headache, including clinical features, imaging findings, and follow-up results was done to explore the potential correlation between migraine and unruptured aneurysm. Clinical data and digital subtraction angiography (DSA) results were retrospectively analyzed. All three patients met the diagnostic criteria for migraine without aura stated in the second edition of the International Classification of Headache Disorders, established by the International Headache Society in 2004. The DSA results suggested that the aneurysms occurred in the anterior communicating artery (two cases) and in the internal carotid artery (one case); the migraine attacks disappeared after aneurysm embolization, with a follow-up time of 6, 10, and 16 months in the three cases, respectively. The pathogenesis of migraine is not fully understood; however, the potential correlation between migraine attack and unruptured saccular aneurysm needs attention, and the specific pathogenesis should be further investigated.
Purpose The purpose of this article is to evaluate the efficacy and safety of covered stent implantation for large intracranial aneurysms treated with stent-assisted coiling. Materials and methods Seven patients with a cerebral aneurysm were selected for this study. The aneurysms were located at the cavernous segment of the internal carotid artery in three cases, the supraclinoid segment in two and the vertebrobasilar junction in one. Aneurysm diameter was 10–25 mm. Mass effect symptoms occurred in six patients, epistaxis in one and subarachnoid hemorrhage in one. All patients underwent endovascular reconstruction with stent-assisted coiling and a covered stent. Five had undergone conventional endovascular embolization with stent-assisted coiling three to six months previously; the covered stent was then navigated through the existing stent and deployed to cover the aneurysm neck. In two cases, the covered stent was deployed after stent-assisted coiling in a single procedure. Results Angiography showed that all aneurysms were excluded from the circulation and parent arteries were preserved. No technical adverse events occurred. At the one- to two-year follow-up, complete resolution of clinical symptom had occurred in six patients and partial resolution in one. No recurrent aneurysm filling and no hemodynamic stenosis was observed. Conclusion Endovascular reconstruction combining a covered stent with stent-assisted coiling could be an effective and safe strategy for the treatment of large cerebral aneurysms.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.