Aim:To describe the relationship between aneurysm size and location and the prevalence of headache at diagnosis and three-and-six-month follow-up in a sample of patients with UIAs.
Material and Methods:In this cohort study, patients were diagnosed with UIAs by digital subtraction angiography. Follow-up visits occurred three and six months after the diagnosis. Headache presence was registered and further classified by phenotypes. After DSA, recorded variables were: aneurysm number, morphology, location, and size (diameter [W], neck [N], and dome-neck distance [H]). The aspect ratio (H/N) and the dome/neck ratio (W/N) were calculated. The outcome of this study was the self-reported headache status at follow-up.
Results:Data from 42 patients and 46 aneurysms were available, 81.0% women, with a mean age of 57.4±14.3 years. Headache was reported by 61.9% of the patients. The pain phenotype was tension-type in 38.1%, migraine in 11.9%, neuralgia in 2.4%, and unclassifiable in 9.5%. The median (min-max) measurements were W=5.05 (0.8922.9); N=3.02 (0.5217.9); H=5.08 (0.9223.0); aspect ratio 1.59 (0.6817.69) and W/N ratio 1.65 (0.6216.92). Thirty-three patients (37 aneurysms) received treatment, 47.8% by surgical clipping and 32.6% by endovascular occlusion. In treated patients, the headache persisted in 14.3% on the first and 9.5% on the second visit. There were no differences in any registered variables between patients with and without headaches at follow-up.
Conclusion:This study found data that supports that headache in patients with UIAs improves after treatment and that such improvement is probably unrelated to the size and shape of the UIAs.
