title: Characteristics of Headache After an Intracranial Endovascular Procedure: A Prospective Observational Study.
abstract: BACKGROUND
  Two editions of the International Classification of Headache Disorders (ICHD) diagnostic criteria for "Headache attributed to an intracranial endovascular procedure" have been published, in 2004 and 2013.1,2Despite studies that have suggested that the former is not very practical, the ICHD-3 beta did not contain major changes. Moreover, so far no consensus exists regarding characteristics of headache after intracranial endovascular procedure. Thus, there is a need for sound suggestions to improve the ICHD-3 beta diagnostic criteria.
  
  
  METHODS
  Using a prospective design, we identified consecutive patients with unruptured intracranial aneurysms (UIAs) with neuroendovascular treatment from January 2014 to December 2014.
  
  
  RESULTS
  In total, 73 patients were enrolled, and 58 patients ultimately completed the 6-month follow-up. After the procedure, five of the 29 patients (17.2%) with pre-existing headache experienced marked worsening after the procedure, while seven of the 29 patients without prior headache developed new-onset headache post-procedurally. The headaches started within 24 hours, with a mean duration of 24-72 hours. The headaches were moderate to severe. The eligibility of these events to be considered headaches caused by neuroendovascular procedures according to the ICHD-3 beta diagnostic criteria for designation was far from ideal.
  
  
  CONCLUSIONS
  Most cases of markedly worsening headaches and new-onset headaches started within 24 hours and persisted longer than that specified in the ICHD-3 beta diagnostic criteria. Moreover, considering that some items are not very practical, the ICHD-3 beta diagnostic criteria should be revised in the light of recent literature reports.
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, PR China.
authors.forename: Linjing
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, PR China.
authors.forename: Xiancong
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, PR China.
authors.forename: Hai
authors.initials: H
authors.lastname: Di
authors.affiliation: Department of Neurology, Heilongjiang Provincial Hospital, Harbin, PR China.
authors.forename: Tao
authors.initials: T
authors.lastname: Feng
authors.affiliation: Department of Neurology, The First Hospital Affiliated to the Chinese PLA General Hospital, Beijing, PR China.
authors.forename: Yunxia
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, PR China.
authors.forename: Xiangyu
authors.initials: X
authors.lastname: Cao
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, PR China.
authors.forename: Baomin
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, PR China.|Department of Neurology, Hainan Branch of Chinese PLA General Hospital, Sanya, PR China.
authors.forename: Ruozhuo
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Neurology, Chinese PLA General Hospital, Beijing, PR China.
authors.forename: Shengyuan
authors.initials: S
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology*; D011446:Prospective Studies; D012189:Retrospective Studies; D055815:Young Adult
keywords: ICHD-3 beta; diagnostic criteria; headache; intracranial endovascular procedure