Effect of Size and Location of Unruptured Intracranial Aneurysms on Self-Reported Headache.

Juan M Marquez-Romero, Dulce A Espinoza-López, Juan M Calleja-Castillo, Fernando Zermeño-Pöhls, Rogelio Salinas-Gutiérrez
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Abstract

Aim: To describe the relationship between aneurysm size and location with the prevalence of headache at diagnosis and three- and six-month follow-up in a sample of patients with UIA.

Material and methods: In this cohort study, patients were diagnosed with UIAs by digital subtraction angiography (DSA). Follow-up visits occurred three and six months after the diagnosis. Headache presence was registered, and headache was further classified by phenotypes. After DSA, the 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% of patients were 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 (0.89-22.9); N=3.02 (0.52-17.9); H=5.08 (0.92-23.0); aspect ratio 1.59 (0.68-17.69) and W/N ratio 1.65 (0.62-16.92). Thirty-three patients (37 aneurysms) received treatment, 47.8% by surgical clipping and 32.6% by endovascular occlusion. In the treated patients, headaches had persisted in 14.3% until the first visit and in 9.5% until the second visit. There were no differences in any registered variables between patients with and without headaches at follow-up.

Conclusion: In this study, data was found that support that headaches in patients with UIAs improve after treatment and that such improvement is probably unrelated to the size and shape of the UIAs.

未破裂颅内动脉瘤的大小和位置对自我报告头痛的影响。
目的:描述UIA患者样本中动脉瘤的大小和位置与诊断时头痛发生率和3-6个月随访时头痛发生率之间的关系:在这项队列研究中,患者通过数字减影血管造影术确诊为 UIAs。诊断后三个月和六个月进行随访。对头痛的存在进行登记,并按表型进一步分类。数字减影血管造影后,记录的变量包括:动脉瘤数目、形态、位置和大小(直径[W]、颈部[N]和穹颈距离[H])。计算了纵横比(H/N)和穹颈比(W/N)。本研究的结果是随访时自我报告的头痛状况:共有 42 名患者和 46 个动脉瘤的数据,其中 81.0% 为女性,平均年龄(57.4±14.3)岁。61.9%的患者报告头痛。疼痛表型为紧张型占 38.1%,偏头痛占 11.9%,神经痛占 2.4%,无法分类占 9.5%。测量结果的中位数(最小值-最大值)为 W=5.05(0.89-22.9);N=3.02(0.52-17.9);H=5.08(0.92-23.0);长宽比 1.59(0.68-17.69)和 W/N 比 1.65(0.62-16.92)。33名患者(37个动脉瘤)接受了治疗,其中47.8%接受了手术夹闭,32.6%接受了血管内闭塞。在接受治疗的患者中,14.3%在第一次就诊时头痛持续存在,9.5%在第二次就诊时头痛持续存在。有头痛和没有头痛的患者在随访时没有任何登记变量的差异:这项研究发现的数据支持UIA患者的头痛在治疗后会有所改善,而且这种改善可能与UIA的大小和形状无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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