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Clinical Trial
. 2011 Jul;31(10):1082-9.
doi: 10.1177/0333102411398155. Epub 2011 Mar 11.

Headache outcomes following treatment of unruptured intracranial aneurysms: a prospective analysis

Todd J Schwedt  1 , Robert W Gereau, Karen Frey, Evan D Kharasch
Affiliations
Clinical Trial

Headache outcomes following treatment of unruptured intracranial aneurysms: a prospective analysis

Todd J Schwedt et al. Cephalalgia. 2011 Jul.

Abstract

Objective: To analyze headache patterns prior to and following treatment of unruptured intracranial aneurysms and identify factors associated with different headache outcomes.

Methods: A prospective observational study of patients being treated for unruptured intracranial aneurysms. Headache patterns were established prior to aneurysm treatment and for 6 months following treatment. Factors associated with different headache outcomes were investigated.

Results: In all patients (n = 44), 90-day headache frequency decreased from an average of 31 days prior to aneurysm treatment to 17 days following treatment (p < 0.001). In patients with active pretreatment headaches (n = 28), 90-day headache frequency decreased from 49 days to 26 days (p = 0.002). Headache frequency was reduced in 68% of patients, while 9% of patients had new or worsened headaches following aneurysm treatment. Pretreatment migraine, more severe pretreatment headaches, higher pretreatment trait anxiety, and stent-assisted aneurysm coiling were associated with a lack of headache improvement.

Conclusions: The majority of patients with headaches at the time of aneurysm treatment had reductions in headache frequency during the 6 months following treatment. Potential risk factors for poor headache outcomes were identified but need to be studied further.

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Figures

Figure 1
Figure 1
Study enrollment.
Figure 2
Figure 2
Headache frequency pre- and post-aneurysm treatment. A. Headache frequency pre- and post-aneurysm treatment in all patients. Examination of the whole sample (n=44) reveals a significant reduction in headache frequency (headache days/90 days) following aneurysm treatment. Six-month headache frequency was significantly lower than pretreatment frequency (13 days/90 days vs. 31 days/90 days, p=0.02). Values are group means. Error bars indicate + 1 SD. *indicates p=0.02. B. Headache frequency pre- and post-aneurysm treatment in patients with active pretreatment headaches. Examination of patients with active headache disorders prior to aneurysm treatment (n=28) reveals a significant reduction in headache frequency (headache days/90 days) following aneurysm treatment. Six-month headache frequency was significantly lower than pretreatment frequency (24 days/90 days vs. 49 days/90 days, p=0.03). Values are group means. Error bars indicate + 1 SD. *indicates p=0.03.
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References

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