White Paper

The Impact of the Endovascular Treatment of Cerebral Aneurysms on Headaches

Objective: The co-occurrence of headaches and cerebral aneurysms is common in clinical practice, although a clear causal relationship has not been ascertained. We aimed to investigate the impact of endovascular obliteration of aneurysms on headaches using a cross-sectional, prospective, open-label protocol. We also sought to characterize the preexisting head- aches in patients harboring cerebral aneurysms using the International Classification of Headache Disorders criteria.

Methods: A total of 33 patients were recruited into the study and under- went endovascular treatment for obliteration of their aneurysms. A standardized survey was administered before and 3 to 6 months after the procedure, documenting the HIT-6 scores as well as the headache frequency.

Results: The study cohort included 25 women and 8 men. In 61% of cases, the aneurysms were located in the posterior circulation. We achieved grade 0 or 1 obliteration of aneurysms in 100% of cases and there were no complications. The mean for HIT-6 scores were 52.3 at baseline and 49.6 postprocedure (student test, < 0.047). The head- ache frequency measured as total headache days per month did not demonstrate statistical significance. Our data indicated that more than half of our cohort had preexisting headaches which fulfilled the criteria for a primary headache disorder. These individuals showed a more robust response to the intervention compared with the remainder of the group, although the P-value per se was not considered statistically significant due to the small sample size.

Conclusions: Endovascular treatment of the aneurysms mitigates the headache-related disability.

Key Words: cerebral aneurysms, headache, endovascular coiling of aneurysms

(The Neurologist 2017;22:215–218)

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Mandy J. Binning,