Research Note Clinical reports and analysis of patients with clinical manifestations of migraine-like headache and unruptured aneurysm

Abstract

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.

Symptomatic migraine: A systematic review to establish a clinically important diagnostic entity

“…Eight of the 73 cases were reported by the authors as symptomatic migraine without aura and fulfilled the ICHD criteria for MWoA 20,24,28,33,45,50,119 . In two cases, headache was side‐locked to the side of the lesion.…”

“…A total of 53 items were labeled as “Cases—Structural” (70 individual case reports in total) 12–64 (Table ), 34 as “Cases—Nonstructural” (50 individual case reports in total) 65–98 (Table ), and 19 as “Groups” (384 cases in total) 99–117 (Table ). In addition, from two case series of three patients, 118,119 three cases were included in “Cases—Structural,” and three in “Cases—Other.” In one case, additional information was gathered from a previous report of the same case 38,120 …”

“…Eight of the 73 cases were reported by the authors as symptomatic migraine without aura and fulfilled the ICHD criteria for MWoA. 20,24,28,33,45,50,119 In two cases, headache was side-locked to the side of the lesion. Types of lesions were meningiomas (n = 3, at least one temporal); brainstem gliosis (n = 1); frontal AVM (n = 1); fibrous dysplasia of the ethmoid bone (n = 1); carotid artery occlusion (n = 1); carotid artery aneurysm (n = 1); and ectasia, elongation, and sinuosity of vertebral and basilar arteries (n = 1).…”

“…Six of the 53 reported cases of symptomatic MWoA fulfilled the ICHD criteria for MWoA. 73,78,119 Assumed underlying conditions were superior oblique myokymia (n = 1), aneurysm of the anterior communicating artery (n = 2), and Susac syndrome (n = 3). None of these cases fulfilled our working criteria for symptomatic migraine or possible symptomatic migraine.…”

Headache and Treatment of Unruptured Intracranial Aneurysms

“…Symptoms occasionally improve after treatment of the aneurysm. [9][10][11][12][13][14][15] In prior reports, aneurysm treatment was followed by improvement in severity or frequency of headache in 59%-92% of patients, regardless of the type of treatment (endovascular or surgical). [16][17][18][19] However, these studies included patients in which the aneurism had been diagnosed in the workup of various conditions other than headache.…”