The Risk of Headache Attributed to Surgical Treatment of Intracranial Aneurysms: A Cohort Study
The Risk of Headache Attributed to Surgical Treatment of Intracranial Aneurysms: A Cohort Study
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DOI：
10.1111/head.12165
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发表时间：
2013-11-01
期刊：
影响因子：
5
通讯作者：
Rocha-Filho, Pedro A. S.
中科院分区：
文献类型：
--
作者：
Magalhaes, Joao E.;Azevedo-Filho, Hildo R. C.;Rocha-Filho, Pedro A. S.
本研究的目的是评估接受手术治疗的颅内动脉瘤患者发生头痛的风险。背景开颅手术后头痛的风险从未被研究过。方法对2009年5月至2010年10月连续住进巴西餐厅医院的颅内动脉瘤患者在接受手术或非手术治疗前进行访谈。干预后随访4个月。手术后使用国际头痛协会的头痛标准，并对栓塞术后的头痛进行调整(同侧动脉瘤的最大疼痛强度)。我们还使用了头痛影响测试、医院焦虑和抑郁量表以及Epworth嗜睡量表。结果101例患者中，53例患者接受了开颅手术，48例患者接受了栓塞术。手术组更年轻，女性更少。术后头痛发生率为54.9%(28/51)，栓塞术后头痛发生率为25.5%(12/47)，相对危险度为2.15，95%可信区间为1.24~3.72。持续性头痛的发生率在两组间无差异。干预后头痛的唯一危险因素是开颅手术(优势比=2.6；95%可信区间1.1~6.7)，持续性头痛的唯一危险因素是治疗前的焦虑(优势比=8.5；95%可信区间1.7~42.3)。治疗后的头痛与介入治疗后焦虑或抑郁的风险无关。结论开颅手术患者治疗后头痛的风险增加。干预前有焦虑的患者3个月后持续性头痛的发生率较高。
ObjectivesThe aim of this study was to assess the risk of headache in patients undergoing surgical treatment of intracranial aneurysms.BackgroundThe risk of the post-craniotomy headache has never been studied.MethodsPatients with intracranial aneurysm, who were consecutively admitted to the Hospital da RestauracAo, Brazil, from May 2009 to October 2010, were interviewed before they underwent surgical or non-surgical treatment of the aneurysms. The patients were followed for 4 months after intervention. The International Headache Society criteria for post-craniotomy headache were used after surgery and adapted for headache after embolization (maximum intensity of pain on the same side of the aneurysm). We also used the Headache Impact Test, the Hospital Anxiety and Depression Scale, and the Epworth Sleepiness Scale.ResultsOf 101 patients enrolled, 53 patients underwent craniotomy and 48 patients embolization. The surgery group was younger and had fewer women. The incidence of headache was 28/51 cases (54.9%) after surgery and 12/47 cases (25.5%) after embolization (relative risk=2.15; 95% confidence interval [CI] 1.24-3.72). The incidence of persistent headache was not different between the 2 groups. The only risk factor for headache after the intervention was craniotomy (odds ratio=2.6; 95% CI 1.1-6.7) and for persistent headache was anxiety prior to treatment (odds ratio=8.5; 95% CI 1.7-42.3). The headache after treatment was not associated with the risk of anxiety or depression after the intervention.ConclusionsPatients who underwent craniotomy had an increased risk of headache after treatment of intracranial aneurysms. The incidence of persistent headache after 3 months was higher among patients who had anxiety before the intervention.