Clinical features and risk factors of angiography headache and evaluation of its relationship to primary headaches

Abstract

Introduction. Angiography headache is defined as a new headache caused directly by cerebral angiography. We aimed to investigate the prevalence and clinical characteristics of angiography headache, and its relationship with primary headaches.Material and methods. This single-centre prospective cohort study was carried out in our tertiary healthcare centre. Patients who had undergone a diagnostic cerebral angiography procedure between March 2016 and June 2017 were included in the study. During and after the procedure, we evaluated the patients in terms of occurrence of headache, and, if present, details about time to onset of headache after cerebral angiography, duration of headache, accompanying symptoms (nausea, vomiting, photophobia and phonophobia), and degree and severity of pain.Results. A total of 226 patients were included in the study. The prevalence of angiography headache was found to be 22.1% (n = 50). While angiography headache started in the first six hours in 92% (n = 46) of the patients, it started after 24 hours of the angiography procedure in only 4% (n = 2). Compressive headache was the most common type, described by 64% of the patients, whereas 4% of the patients described pricking or stabbing sensations. Angiography headache was associated with female gender, higher educational level, and a history of primary headache. Conclusion.Angiography headache is an important clinical entity that must be considered during and after angiography. Experiencing angiography headache is more common among patients with a history of primary headache.

The applicability research of the diagnostic criteria for 6.7.2 angiography headache in the international classification of headache disorders-3rd edition

“…We propose to change the definition of "occurring later, but within 24 hours" to "occurring later, but within 1 week after angiography". Patients with history of headache are more likely to have angiography headache has been established in previous and our studies [2][3][4][5][6]20]. In our study, the history of headache was a risk factor for angiography headache.…”

“…The possible explanation is that women demonstrating lower pain thresholds and the fluctuations of sex hormones especially estrogen and progesterone may cause a change in the prevalence or intensity of headache [1,18,19]. Previous history of headache as a risk factor for angiography headache had been established in many studies [2][3][4][5][6]20]. The possible mechanism maybe that some individuals with a history of headache had lower thresholds for trigeminal activation [2,7].…”

Clinical features and risk factors of angiography headache and evaluation of its relationship to primary headaches — an important but neglected problem

“…A more recent study [5] included 327 patients of whom 55.6% developed AH, mainly with a previous history of headaches. In the light of known reports, the current work [1] is of considerable value -the study group consisted of 226 patients and the frequency of AH was found to be 22%. The authors define the AH risk group as female, higher educated patients with a previous history of primary headache.…”

Analysis of risk factors associated with cerebral angiography headache

“…The literature has relatively few investigations of AH and its risk factors. Female sex was associated with AH in the study of Gil-Gouveia et al, 2 Aktan et al, 7 and Demir et al 6 Among the studies that found an association between AH and previous history of headaches, we name Ramadan et al, 5 Aktan et al, 7 and Demir et al 6 Regarding demographic factors, a higher education level was associated with AH in the publications of Kwon et al 4 and Demir et al 6 …”

“…In the literature, reports of its frequency are highly variable (0.3 to 55.6%). 2 3 4 5 6 It is usually underestimated by neuroradiologists, possibly due to its usually benign and transient character. Nonetheless, in our clinical practice, we see that patients with a previous history of AH tend to be resistant to performing new cerebral DSAs.…”