Headache Outcomes After Treatment of Unruptured Intracranial Aneurysm

Dandurand, Charlotte; Parhar, Harman S.; Naji, Faysal; Prakash, Swetha; Redekop, Gary; Haw, Charles S.; Prisman, Eitan; Gooderham, Peter

doi:10.1161/strokeaha.119.026864

Cited by 11 publications

(2 citation statements)

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“…In our case, the endovascular intervention (bilateral flow diverting stent placement) not only resolved the coital headache but also improved the patient's regular migraine. This is consistent with previous studies that demonstrated coil embolization of unruptured aneurysms resulted in a reduction of the severity of regular headaches in a majority of patients [12][13][14].…”

Section: Discussionsupporting

confidence: 93%

Recurrent, Severe Coital Headaches Associated With Bilateral Carotid Artery Aneurysms and the Effect of Endovascular Treatment

Martinez Arellano,

Lu,

Ishac

et al. 2024

Cureus

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Headaches are one of the most common chief complaints in the outpatient setting. Distinguishing between benign and life-threatening headaches can be difficult, particularly in the setting of a pre-existing history of headaches. Here, we present a 41-year-old female with a past medical history of migraines and uterine leiomyoma status post hysterectomy about nine months ago who presented to the clinic for severe coital headaches and worsening migraines starting eight months ago. Computer tomography angiogram (CTA) head and neck demonstrated bilateral para-ophthalmic internal carotid artery (ICA) aneurysms (right, 7.5, left 6 mm). A diagnostic cerebral angiogram (DSA) was subsequently done and confirmed the CTA findings. The patient underwent left and right flow-diverting stent placement two and four months later, respectively. One week after the right ICA stent placement, her headaches had improved to one to two times per week. At six months after the stent placement, she resumed her normal sex life and her migraines returned to baseline. Our case suggests that recurrent severe coital headaches are associated with bilateral carotid artery aneurysms. Thus, while assessing a patient with recurrent coital headaches, it is important to have a wide arsenal of differentials to rule out possibly catastrophic causes.

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Section: Discussionsupporting

confidence: 93%

Recurrent, Severe Coital Headaches Associated With Bilateral Carotid Artery Aneurysms and the Effect of Endovascular Treatment

Martinez Arellano,

Lu,

Ishac

et al. 2024

Cureus

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“…For example, a "sentinel headache" is well-described in the literature and is thought to be associated with local thrombosis (12). Chronic headaches may have variable presentations but most frequently resemble migraines (13). In 2013, Lebedeva et al ( 14) conducted a prospective case-control study of 199 patients and found that migraine-like headaches without aura were significantly associated with saccular aneurysms up to 1 year before rupture (odds ratio [OR], 6.7; 95% confidence interval [CI], 3.8-11.9; p ≤ 0.001).…”

Section: Discussionmentioning

confidence: 99%

A comprehensive assessment of self-reported symptoms among patients harboring an unruptured intracranial aneurysm

et al. 2023

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BackgroundApproximately 3.2%–6% of the general population harbor an unruptured intracranial aneurysm (UIA). Ruptured aneurysms represent a significant healthcare burden, and preventing rupture relies on early detection and treatment. Most patients with UIAs are asymptomatic, and many of the symptoms associated with UIAs are nonspecific, which makes diagnosis challenging. This study explored symptoms associated with UIAs, the rate of resolution of such symptoms after microsurgical treatment, and the likely pathophysiology.MethodsA retrospective review of patients with UIAs who underwent microsurgical treatment from January 1, 2014, to December 31, 2020, at a single quaternary center were identified. Analyses included the prevalence of nonspecific symptoms upon clinical presentation and postoperative follow-up; comparisons of symptomatology by aneurysmal location; and comparisons of patient demographics, aneurysmal characteristics, and poor neurologic outcome at postoperative follow-up stratified by symptomatic versus asymptomatic presentation.ResultsThe analysis included 454 patients; 350 (77%) were symptomatic. The most common presenting symptom among all 454 patients was headache (n = 211 [46%]), followed by vertigo (n = 94 [21%]), cognitive disturbance (n = 68[15%]), and visual disturbance (n = 64 [14%]). Among 328 patients assessed for postoperative symptoms, 258 (79%) experienced symptom resolution or improvement.ConclusionThis cohort demonstrates that the clinical presentation of patients with UIAs can be associated with vague and nonspecific symptoms. Early detection is crucial to prevent aneurysmal subarachnoid hemorrhage. It is imperative that physicians not rule out aneurysms in the setting of nonspecific neurologic symptoms.

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