Effect of Endovascular Treatment on Headaches in Patients with Unruptured Intracranial Aneurysms

Background.-Patients with unruptured intracranial aneurysms often present with headaches. Objective.-To determine the effect of endovascular treatment on the character and frequency of headaches in patients with unruptured intracranial aneurysms. Methods.-We reviewed the medical records of all patients who underwent endovascular treatment for unruptured intracranial aneurysms within a 9.5-year period. These patients were mailed a standard questionnaire in which they were asked about the frequency and character of any headache experienced before or after (or both) endovascular treatment. They were also asked to grade improvement or worsening of headaches after the procedure as mild (activities of daily living were not affected), moderate (activities of daily living were affected), or significant (the change resulted in an ability to perform new activities of daily living or an inability to perform previous activities of daily living). Results.-Forty-seven patients with unruptured aneurysms who underwent Guglielmi detachable coil embolization responded to the questionnaire. Of these, 32 patients (mean age, 52.7 years [SD, 13.4]; 22 were women) had experienced headaches before the procedure. Nineteen patients (59%) reported improvement in severity of headaches after embolization. Improvement was graded as significant by 7 patients, moderate by 8, and mild by 4. Two patients (6%) reported worsening severity of headaches graded as moderate. Five of 15 patients without headaches before embolization reported onset of mild (n = 4) or severe (n = 1) headaches after treatment. Conclusion.-Guglielmi detachable coil embolization of unruptured intracranial aneurysms was associated with reduction in severity of headaches in the majority of patients who had experienced preprocedural headaches.