Effect of Endovascular Treatment on Headaches in Patients With Unruptured Intracranial Aneurysms

Qureshi, Adnan I.; Suri, M. Fareed K.; Kim, Stanley H.; Olson, Kenneth B.; Siddiqui, Amir M.; Yahia, Abutaher M.; Guterman, Lee R.; Hopkins, L. Nelson

doi:10.1046/j.1526-4610.2003.03211.x

Cited by 43 publications

(61 citation statements)

References 21 publications

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“…[13][14][15] Regarding unruptured intracranial aneurysms, many previous investigations [16][17][18][19][20] have focused on the risks for rupture and hemorrhage while the aneurysms were left untreated, as well as the burden of risk that is associated with treatment modalities (surgical vs endovascular treatment) when the aneurysms are to be treated. 21,22 Several studies 6,[23][24][25] have also mentioned the effect of treatment of unruptured intracranial aneurysms on headache. However, literature specifically evaluating headache outcome after endovascular treatment of elderly patients with unruptured aneurysms is rare.…”

Section: Discussionmentioning

confidence: 99%

“…5 The severity and frequency of headache may change in different ways, including improvement, aggravation, and new onset after endovascular treatment of intracranial aneurysms. 6 With a globally aging population, the number of elderly patients with intracranial aneurysms increases rapidly. Because of possible devastating consequences of aneurysm rupture and low morbidity and mortality rates of endovascular treatment, more and more elderly patients with unruptured intracranial aneurysms have been treated endovascularly.…”

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confidence: 99%

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Effect of Endovascular Treatment on Headache in Elderly Patients with Unruptured Intracranial Aneurysms

Duan

et al. 2012

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Effect of Endovascular Treatment on Headache in Elderly Patients with Unruptured Intracranial Aneurysms

Duan

et al. 2012

AJNR Am J Neuroradiol

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“…1,10,15 However, one study demonstrated that the use of stent assistance was not associated with improvement in headache symptoms in patients with pretreatment headaches or new headaches following treatment (1 of 5 patients improved). 19 The observed prevalence in the current series of migraine headaches (29%) and subsequent improvement of those headaches following stent-mediated embolization of aneurysms in 54% of those patients echoes the reports of sustained benefit in pain scores following aneurysm obliteration while demonstrating that the benefit of aneurysm embolization on headache symptoms may indeed persist in the population of patients undergoing stent assistance for treatment of their aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Neuro-ophthalmic effects of stenting across the ophthalmic artery origin in the treatment of intracranial aneurysms

Heller¹,

Lawlor

Hedges

et al. 2014

JNS

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Object The benefits of treating intracranial aneurysms in the region of the anterior visual pathways are well understood. However, the adverse effects of endovascular stenting across the ophthalmic artery have received little attention. The authors reviewed their experience with patients who had stents deployed across the ophthalmic artery origin. Methods Patients' medical charts and imaging studies were reviewed to identify all patients with a non–flow diverting stent deployed over the ophthalmic artery origin for the treatment of intracranial aneurysms. All patients with neuro-ophthalmic complaints were referred for formal ophthalmological evaluation. Results A total of 104 consecutive patients with 106 aneurysms were identified to meet criteria for inclusion in the study cohort. Preoperatively, 30 patients (29%) described headache symptoms and 32 patients (31%) reported visual complaints. Of the patients with preoperative headaches, 15 (54%) of 28 patients for whom follow-up was available experienced improvement in their symptoms. Of the patients with preoperative visual complaints, improvement was noted in 11 (41%) of the 27 patients for whom follow-up was available, 9 (33%) of 27 patients reported no change in visual symptoms, and 7 (26%) of 27 patients reported progression of symptoms. Visual field defects developing posttreatment were noted to occur in 8 (7.7%) of 104 patients: 3 with immediate postoperative retinal infarcts, 1 with perioperative hemianopia that resolved by the time of discharge, 1 with a subjective visual field defect, 1 with subjective migratory visual field defects, and 2 with nonspecific visual symptoms. Compressive symptoms from aneurysm mass effect were noted in 6 patients preoperatively, with 4 of those patients experiencing persistent worsening, resolution in 1 case, and no change in 1 case. One patient developed a novel cranial nerve palsy from mass effect in the immediate postoperative period. Conclusions Deployment of stents across the ophthalmic artery origin for the treatment of intracranial aneurysms appears to be relatively safe with regard to visual outcomes. Neuro-ophthalmic complaint resolution rates were comparable to endovascular procedures that do not employ stents, with headache resolution rates comparable to coil-only aneurysm obliteration and low rates of retinal ischemic events. For patients presenting with mass effect, stent-assisted coiling appears to be less effective than microsurgery with decompression for relief of compressive symptoms.

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“…77) Headache associated with the dura of the cavernous sinus or other skull base regions often improves after surgical treatment. 15,76) Coil embolization in 10 patients with large internal carotid artery aneurysms with headache or cranial nerve signs resulted in headache disappearing in all patients although Symptomatic Unruptured Cerebral Aneurysms aneurysm volume was larger than that before surgery due to the coil embolization; the improved headache may be due to reduced transmitted pulsations. 79) Recently, chronic headache was assessed after surgical treatment of unruptured cerebral aneurysms.…”

Section: Headache and Unruptured Cerebral Aneurysmsmentioning

confidence: 95%

Symptomatic Unruptured Cerebral Aneurysms: Features and Surgical Outcome

Date

2010

Neurol. Med. Chir.(Tokyo)

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Development of less invasive imaging studies, such as magnetic resonance angiography, has increased the chances that unruptured cerebral aneurysms are found. The rupture risk of``symptomatic'' aneurysms is higher than for``asymptomatic'' aneurysms; so``symptomatic'' aneurysms are more often surgically treated. Many reviews examine``asymptomatic'' unruptured cerebral aneurysms, but few evaluate``symptomatic'' aneurysms. The author has treated many patients with symptomatic unruptured cerebral aneurysms and found that improved cranial nerve signs can be expected if the surgical treatment is performed before the symptoms become irreversible; the critical period is approximately 3 months. It is important to suppress the pulsation of the aneurysms compressing the cranial nerves; both a clipping procedure and endovascular coiling are effective. Cranial nerve signs are more commonly the symptoms of unruptured cerebral aneurysms, but large to giant aneurysms can also be the causes of hemiparesis, hydrocephalus, epilepsy, or even cerebral infarction. This review summarizes the features and surgical outcome of symptomatic unruptured cerebral aneurysms.

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Effect of Endovascular Treatment on Headaches in Patients With Unruptured Intracranial Aneurysms

Abstract: Guglielmi detachable coil embolization of unruptured intracranial aneurysms was associated with reduction in severity of headaches in the majority of patients who had experienced preprocedural headaches.

Cited by 43 publications

References 21 publications

Effect of Endovascular Treatment on Headache in Elderly Patients with Unruptured Intracranial Aneurysms

Effect of Endovascular Treatment on Headache in Elderly Patients with Unruptured Intracranial Aneurysms

Neuro-ophthalmic effects of stenting across the ophthalmic artery origin in the treatment of intracranial aneurysms

Symptomatic Unruptured Cerebral Aneurysms: Features and Surgical Outcome

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