Gil-Gouveia Raquel, Fernandes Sousa Rita, Lopes Leonor, Campos Jorge, Pavão Martins Isabel
Centro de Estudos Egas Moniz, Instituto de Medicina Molecular, Lisbon's Faculty of Medicine, Av. Prof. Egas Moniz, 1649-035, Lisboa, Portugal.
J Neurol. 2007 May;254(5):591-6. doi: 10.1007/s00415-006-0330-9. Epub 2007 Apr 6.
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.
To determine the frequency of headaches during endovascular procedures (HdEVP) and to define their characteristics and risk factors for their occurrence.
Prospective cross-sectional observational study of adult patients undertaking cerebral angiography or endovascular procedures, recording HdEVP clinical features, previous headache history and procedural variables.
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).
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.
在脑血管造影或血管内介入手术期间发生头痛是一个定义不明确的问题，因为关于其发生率、危险因素、发病机制以及对未来疼痛管理的影响的信息有限。
确定血管内介入手术期间头痛（HdEVP）的发生率，并明确其特征和发生的危险因素。
对接受脑血管造影或血管内介入手术的成年患者进行前瞻性横断面观察研究，记录HdEVP的临床特征、既往头痛史和手术变量。
共评估了122例手术。13例患者在诊断性和治疗性手术中均出现了HdEVP。疼痛被描述为短暂的、刺痛性的或轻度至中度强度的局部压迫感，在操作血管的同侧感觉到。其发生与治疗性干预（p = 0.007）、女性性别（p = 0.015）以及每月头痛发作超过4次的既往史（p = 0.018）有关。
HdEVP是一种罕见的短暂性头痛，未来应进一步评估。其发病机制可能与机械性血管扩张有关，这会在易感个体中激活三叉神经血管伤害感受系统。
