Headaches during angiography and endovascular procedures.
BACKGROUND
The occurrence of headaches during cerebral angiography or endovascular procedures is an ill-defined issue, as limited information is available to define its frequency, risk factors, pathogenesis and implications for future pain management.


OBJECTIVE
To determine the frequency of headaches during endovascular procedures (HdEVP) and to define their characteristics and risk factors for their occurrence.


METHODS
Prospective cross-sectional observational study of adult patients undertaking cerebral angiography or endovascular procedures, recording HdEVP clinical features, previous headache history and procedural variables.


RESULTS
One hundred and twenty two procedures were evaluated. HdEVP occurred in 13 patients, both in diagnostic and therapeutic procedures. Pain was described as brief, stabbing or localized pressure of mild to moderate intensity, felt ipsilaterally to the manipulated vessel. Its occurrence was associated with therapeutic interventions (p = 0.007), female gender (p = 0.015) and previous history of more than 4 headache episodes per month (p = 0.018).


CONCLUSIONS
HdEVP is an uncommon brief headache that should be further evaluated in the future. Its pathogenesis is probably related to mechanical vessel distension, which activates the trigeminovascular nociceptive system in susceptible individuals.
Gil-Gouveia
Raquel
R
Centro de Estudos Egas Moniz, Instituto de Medicina Molecular, Lisbon's Faculty of Medicine, Av. Prof. Egas Moniz, 1649-035, Lisboa, Portugal. rgilgouveia@netcabo.pt
Fernandes Sousa
Rita
R
Lopes
Leonor
L
Campos
Jorge
J
Pavão Martins
Isabel
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D002533:Cerebral Angiography / Q000009:adverse effects*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D007839:Functional Laterality; D006261:Headache / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014652:Vascular Diseases / Q000175:diagnosis / Q000628:therapy; D014656:Vascular Surgical Procedures / Q000009:adverse effects*