Physicians are seeing an increase in the incidence of unruptured intracranial aneurysms in the elderly population alongside the increase in life expectancy. It is also commonplace for patients with unruptured intracranial aneurysms to present with headache.
Researchers from Guangzhou, China, set out to determine the effect of endovascular treatment on headache and identify factors associated with headache outcome in elderly patients with unruptured intracranial aneurysms.
Chuan-Zhi Duan, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, China, and team carried out a retrospective study of patients who were 65 years of age or older who were treated for unruptured intracranial aneurysms. They assessed headache by a quantitative 11-point headache scale in all patients before and after endovascular treatment and investigated the factors associated with headache outcome by univariate analyses.
Duan et al’s study included a total of 72 patients (mean age, 70 years [range, 65–80 years; 41 women]). Fifty two patients (72.2%) presented with preoperative headache (headache score ≥1). Forty (76.9%) of these reported that their headache score had improved after endovascular treatment. The researchers found that the average headache score was 5.63 preoperatively vs. 2.5 postoperatively (p=0.000). Twenty patients (27.8%) did not have any headache prior to treatment. Of these, two patients (10%) reported the onset of headache after coiling was carried out.
Results from the study showed that preoperative headache score was the only statistically significant predictor of headache outcome, and a higher headache score predicted a lack of headache relief after endovascular treatment (p=0.003).