title: The characteristics and risk factors of headache development after the coil embolization of an unruptured aneurysm.
abstract: OBJECTIVE
  Development of a headache after aneurysm coil embolization is not uncommon but has received little attention. The authors prospectively analyze the characteristics and risk factors of a headache after coiling in patients treated for an unruptured cerebral aneurysm.
  
  
  METHODS
  Ninety patients treated for an unruptured cerebral aneurysm over a period of 1 year, and without a headache history within a month before coiling, were enrolled in this study. All coilings were successfully performed without neurologic complications. After coiling, headache development and intensities were recorded.
  
  
  RESULTS
  Fifty (55.6%) patients experienced a headache (VAS score, 4.5 ± 2.02) at 7.9 (range, 0-72) hours, on average, after coiling, and all headaches resolved within an average of 73.0 (range, 3-312) hours. Univariate analysis showed that the following were significantly associated with the development of a headache: age ≤ 50 years (OR 4.636, 95% CI, 1.414-15.198), hypertension (OR 0.232, 95% CI, 0.095-0.571), a packing attenuation of >25% (OR 3.619, 95% CI, 1.428-9.174), and a previous headache history (OR 2.769, 95% CI, 1.120-6.849). However, binary logistic regression showed that only a packing attenuation of >25% (P = .013, adjusted OR 3.774, 95% CI, 1.320-10.790) and no history of hypertension (P = .019, adjusted OR 3.515, 95% CI, 1.233-10.021) were independently associated with the development of a headache.
  
  
  CONCLUSIONS
  A headache frequently developed after the coiling of unruptured aneurysms. However, headaches were relatively benign and resolved within several days. The present study shows that no hypertension history and a packing attenuation of >25% are risk factors of headache development.
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: G
authors.initials: G
authors.lastname: Hwang
authors.forename: E-A
authors.initials: EA
authors.lastname: Jeong
authors.forename: J H
authors.initials: JH
authors.lastname: Sohn
authors.forename: H
authors.initials: H
authors.lastname: Park
authors.forename: J S
authors.initials: JS
authors.lastname: Bang
authors.forename: S-C
authors.initials: SC
authors.lastname: Jin
authors.forename: B C
authors.initials: BC
authors.lastname: Kim
authors.forename: C W
authors.initials: CW
authors.lastname: Oh
authors.forename: O-K
authors.initials: OK
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000453:epidemiology / Q000517:prevention & control; D004621:Embolization, Therapeutic / Q000706:statistics & numerical data*; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D016896:Treatment Outcome