Skip to main content

Advertisement

SpringerLink
Log in

Incidence and risk factors of postoperative headache after endovascular coil embolization of unruptured intracranial aneurysms

  • Clinical Article - Vascular
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

An Erratum to this article was published on 25 May 2014

Abstract

Background

Endovascular coil embolization for unruptured intracranial aneurysms (UIAs) has gained popularity because of its low morbidity and mortality in a short-term context. However, Headache is sometimes brought about or worsened after endovascular treatment, and this complaint may lead to perplexing situations, albeit infrequently. The aim of this study is to estimate the practical incidence and risk factors of postoperative headache in patients with endovascular embolization of UIAs.

Method

One hundred and thirty patients who underwent endovascular treatment of UIAs between March 2006 and May 2012 were enrolled according to inclusion criteria. From a retrospective chart review, the patients who had worsening or newly developed headache from postoperative day 1 to in-hospital stay were investigated for analyzing risk factors of post-embolization headache. Factors based on patients’ demographics, anatomical and radiological features of the lesions, treatment, utilized devices and outcome were investigated, and statistically verified.

Results

Headache occurred or was exacerbated in 32 patients (24.6 %). Of these, 30 patients showed improvement within days, but two patients with previous migraine history complained of intermittent headache over 3 months after the embolization. Univariate comparison between the headache group and the non-headache group showed that internal carotid artery (ICA) segment aneurysm, stent-assisted coiling, and no history of hypertension were associated with post-embolization headache (p < 0.05). However, stent-assisted coiling and no history of hypertension were significantly associated with post-embolization headache in logistic regression analysis (p < 0.05).

Conclusions

In the current study, stent-assisted coiling and no history of hypertension were important risk factors for headache in patients undergoing endovascular coil embolization for UIAs. Further investigations are still necessary to confirm the correlation of other factors which did not reach statistical significance in post-embolization headache in this limited study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abou-Chebl A, Krieger DW, Bajzer CT, Yadav JS (2006) Intracranial angioplasty and stenting in the awake patient. J Neuroimaging 16:216–223

    Article  PubMed  Google Scholar 

  2. Baldwin RL (1996) Headache prevention in retrosigmoid vestibular nerve section. South Med J 89:375–379

    Article  CAS  PubMed  Google Scholar 

  3. Berge J, Tourdias T, Moreau JF, Barreau X, Dousset V (2011) Perianeurysmal brain inflammation after flow-diversion treatment. AJNR Am J Neuroradiol 32:1930–1934

    Article  CAS  PubMed  Google Scholar 

  4. Dönmez H, Mavili E, Ikizceli T, Durak AC, Kurtsoy A (2009) Stroke secondary to aseptic meningitis after endovascular treatment of a giant aneurysm with parent artery occlusion. Cardiovasc Intervent Radiol 32:801–803

    Article  PubMed  Google Scholar 

  5. Fennelly M, Galletly DC, Purdie GI (1991) Is caffeine withdrawal the mechanism of postoperative headache? Anesth Analg 72:449–453

    Article  CAS  PubMed  Google Scholar 

  6. Hess DR (2004) Retrospective studies and chart reviews. Respir Care 24:1171–1174

    Google Scholar 

  7. Hwang G, Jeong EA, Sohn JH, Park H, Bang JS, Jin SC, Kim BC, Oh CW, Kwon OK (2012) The characteristics and risk factors of headache development after the coil embolization of an unruptured aneurysm. AJNR Am J Neuroradiol 33:1676–1678

    Article  CAS  PubMed  Google Scholar 

  8. Irimia P, Barbosa C, Martinez VE (2005) Paroxysmal hemicranias after carotid aneurysm embolization. Cephalalgia 25:1096–1098

    Article  CAS  PubMed  Google Scholar 

  9. Jackson CG, McGrew BM, Forest JA, Hampf CR, Glasscock ME 3rd, Brandes JL, Hanson MB (2000) Comparison of postoperative headache after retrosigmoid approach: vestibular nerve section versus vestibular schwannoma resection. Am J Otol 21:412–416

    Article  CAS  PubMed  Google Scholar 

  10. Keller JT, Beduk A, Saunders MC (1985) Origin of fibers innervating the basilar artery of the cat. Neurosci Lett 58:263–268

    Article  CAS  PubMed  Google Scholar 

  11. Kim IC, Chun YI, Park CW, Lee U (2006) Angiographic follow-up result of cerebral aneurysms treated with coils covered with polyglycolic-polulactic acid copolymer. J Korean Neurosurg Soc 39:286–291

    Google Scholar 

  12. Martins IP, Baeta E, Paiva T, Campos J, Gomes L (1993) Headaches during intracranial endovascular procedures: a possible model of vascular headache. Headache 33:227–233

    Article  CAS  PubMed  Google Scholar 

  13. Mayberg M, Langer RS, Zervas NT, Moskowitz MA (1981) Perivascular meningeal profections from cat trigeminal ganglia: possible pathway for vascular headaches in man. Science 213:228–230

    Article  CAS  PubMed  Google Scholar 

  14. Murayama Y, Vinuela F, Tateshima S, Song JK, Gonzalez NR, Wallace MP (2001) Bioabsorbable polymeric material coil for embolization of intracranial aneurysms: a preliminary experimental study. J Neurosurg 94:454–463

    Article  CAS  PubMed  Google Scholar 

  15. O’Connor TP, van der Kooy D (1986) Pattern of intracranial and extracranial projections of trigeminal ganglion cells. J Neurosci 6:2200–2207

    PubMed  Google Scholar 

  16. Piotin M, Blanc R, Spelle L, Mounayer C, Piantino R, Schmidt PJ, Moret J (2010) Stent-assisted coiling of intracranial aneurysms: clinical and angiographic results in 216 consecutive aneurysms. Stroke 41:110–115

    Article  PubMed  Google Scholar 

  17. Quasar Grunwald I, Molyneux A, Kühn AL, Watson D, Byrne JV (2010) Influence of coil geometry on intra-aneurysmal packing density: evaluation of a new primary wind technology. Vasc Endovasc Surg 44(4):289–293

    Article  Google Scholar 

  18. Qureshi AI, Suri MF, Kim SH, Olson K, Siddiqui AM, Yahia AM, Guterman LR, Hopkins LN (2003) Effect of endovascular treatment on headaches in patients with unruptured intracranial aneurysms. Headache 43:1090–1096

    Article  PubMed  Google Scholar 

  19. Saito K, Moskowitz MA (1989) Contributions from the upper cervical dorsal roots and trigeminal ganglia to the feline circle of Willis. Stroke 20:524–526

    Article  CAS  PubMed  Google Scholar 

  20. Schwedt TJ, Gereau RW, Frey K, Kharasch ED (2011) Headache outcomes following treatment of unruptured intracranial aneurysms: a prospective analysis. Cephalalgia 31(10):1082–1089

    Article  PubMed Central  PubMed  Google Scholar 

  21. Schwedt TJ, Samples S, Rasmussen P, Stillman M (2005) New headache after endovascular or microsurgical treatment of intracranial aneurysm. Neurology 64(Suppl 1):A401

    Google Scholar 

  22. Silverstein H, Norrell H, Smouha E, Jones R (1989) Combined retrolab-retrosigmoid vestibular neurectomy. An evolution in approach. Am J Otol 10:166–169

    CAS  PubMed  Google Scholar 

  23. Silverstein H, Norrell H, Smouha E, Jones R (1987) Retrolabyrinthine or retrosigmoid vestibular neurectomy: indications. Am J Otol 8:414–418

    CAS  PubMed  Google Scholar 

  24. Takigawa T, Matsumaru Y, Nakai Y, Nakamura K, Hayakawa M, Tsuruta W, Matsumura A (2012) Bioactive coils cause headache and fever after endovascular treatment of intracranial aneurysms. Headache 52(2):312–321

    Article  PubMed  Google Scholar 

  25. Thornton J, Dovey Z, Alazzaz A, Misra M, Aletich VA, Debrun GM, Ausman JI, Charbel FT (2000) Surgery following endovascular coiling of intracranial aneurysms. Surg Neurol 54:352–360

    Article  CAS  PubMed  Google Scholar 

  26. International Study of Unruptured Intracranial Aneurysms Investigators (1998) Unruptured intracranial aneurysms-risk of rupture and risks of surgical intervention. N Engl J Med 339:1725–1733

  27. Wardlaw JM, White PM (2000) The detection and management of unruptured intracranial aneurysm. Brain 123(Pt 2):205–221

    Article  PubMed  Google Scholar 

  28. Yahia AM, Gorodn V, Whapham J, Malek A, Steel J, Fessler RD (2008) Complications of Neuroform stent in endovascular treatment of intracranial aneurysms. Neurocrit Care 8:19–30

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Hanyang University Medical Center, 17 Haengdang-dong, Seongdong-gu, 133-792, Seoul, Korea

    Kyu-Sun Choi, Jung-Hyun Lee, Hyeong-Joong Yi & Hyoung-Joon Chun

  2. Department of Radiology, Hanyang University Medical Center, Seoul, Korea

    Young-Jun Lee

  3. Department of Anesthesia and Pain Medicine, Hanyang University Medical Center, Seoul, Korea

    Dong-Won Kim

Authors
  1. Kyu-Sun Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jung-Hyun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hyeong-Joong Yi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hyoung-Joon Chun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Young-Jun Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dong-Won Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hyeong-Joong Yi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Choi, KS., Lee, JH., Yi, HJ. et al. Incidence and risk factors of postoperative headache after endovascular coil embolization of unruptured intracranial aneurysms. Acta Neurochir 156, 1281–1287 (2014). https://doi.org/10.1007/s00701-014-2095-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-014-2095-8

Keywords

Search

Navigation