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

Acta Neurochirurgica volume 156, pages 1281–1287 (2014)Cite this article

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.

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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

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  1. Kyu-Sun Choi
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  2. Jung-Hyun Lee
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  4. Hyoung-Joon Chun
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Correspondence to Hyeong-Joong Yi.

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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

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

Keywords

  • Embolization
  • Endovascular coiling
  • Intracranial aneurysm
  • Headache