Brazilian experience of the influence of endovascular treatment on headache in patients with ruptured intracranial aneurysms

Background - The characteristics of primary headaches in patients with ruptured brain aneurysm embolization have not been well understood to date. Aims of the study - This study was conducted to evaluate the influence of endovascular treatment (EVT) of ruptured intracranial aneurysm (RIA) and the pattern of previous primary headache. Methods - We evaluated the pattern of headache in patients who suffered a RIA and EVT within one year before the rupture, and prospectively evaluated the characteristics of headache for up to 12 months after EVT. Sixty patients were evaluated and a questionnaire about headache was applied at the time of admission. These patients were contacted 3, 6 and 12 months after treatment to complete the study by filling out follow-up questionnaire on the headache. Results - Thirty-seven patients had headache before the rupture, 16 with tension-type headache (TTH), 11 with migraine without aura, nine with migraine with aura with and one with nonspecific characteristics. There was a significant reduction in the frequency of pain for up to 12 months for patients with TTH (P < 0.001) and migraine without aura (P = 0.012), but there was a reduction in pain intensity over the same period in TTH ( P = 0.002), migraine with aura (P = 0.004) and migraine without aura (P < 0.001). Conclusion - There was a reduction of the primary headache after endovascular treatment of ruptured brain aneurysm.