Division of Neurology, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco, Recife, PE, Brazil.
Headache. 2013 Nov-Dec;53(10):1613-23. doi: 10.1111/head.12165. Epub 2013 Jun 28.
The aim of this study was to assess the risk of headache in patients undergoing surgical treatment of intracranial aneurysms.
The risk of the post-craniotomy headache has never been studied.
Patients with intracranial aneurysm, who were consecutively admitted to the Hospital da Restauração, Brazil, from May 2009 to October 2010, were interviewed before they underwent surgical or non-surgical treatment of the aneurysms. The patients were followed for 4 months after intervention. The International Headache Society criteria for post-craniotomy headache were used after surgery and adapted for headache after embolization (maximum intensity of pain on the same side of the aneurysm). We also used the Headache Impact Test, the Hospital Anxiety and Depression Scale, and the Epworth Sleepiness Scale.
Of 101 patients enrolled, 53 patients underwent craniotomy and 48 patients embolization. The surgery group was younger and had fewer women. The incidence of headache was 28/51 cases (54.9%) after surgery and 12/47 cases (25.5%) after embolization (relative risk = 2.15; 95% confidence interval [CI] 1.24-3.72). The incidence of persistent headache was not different between the 2 groups. The only risk factor for headache after the intervention was craniotomy (odds ratio = 2.6; 95% CI 1.1-6.7) and for persistent headache was anxiety prior to treatment (odds ratio = 8.5; 95% CI 1.7-42.3). The headache after treatment was not associated with the risk of anxiety or depression after the intervention.
Patients who underwent craniotomy had an increased risk of headache after treatment of intracranial aneurysms. The incidence of persistent headache after 3 months was higher among patients who had anxiety before the intervention.
本研究旨在评估颅内动脉瘤手术治疗患者头痛的风险。
从未研究过开颅术后头痛的风险。
2009 年 5 月至 2010 年 10 月，巴西 Restauracao 医院连续收治颅内动脉瘤患者，在接受动脉瘤手术或非手术治疗前对其进行访谈。干预后随访 4 个月。采用国际头痛协会（International Headache Society）开颅术后头痛标准，并对栓塞后头痛（与动脉瘤同侧疼痛的最大强度）进行了改编。我们还使用头痛影响测试（Headache Impact Test）、医院焦虑抑郁量表（Hospital Anxiety and Depression Scale）和嗜睡量表（Epworth Sleepiness Scale）。
101 例患者中，53 例行开颅术，48 例行栓塞术。手术组患者年龄较小，女性较少。术后头痛发生率为 51 例中的 28 例（54.9%），47 例栓塞后头痛发生率为 12 例（25.5%）（相对风险 2.15；95%置信区间 1.24-3.72）。两组持续头痛的发生率无差异。干预后头痛的唯一危险因素是开颅术（比值比 2.6；95%置信区间 1.1-6.7），治疗前焦虑是持续头痛的唯一危险因素（比值比 8.5；95%置信区间 1.7-42.3）。治疗后头痛与干预后焦虑或抑郁的风险无关。
行开颅术的患者颅内动脉瘤治疗后头痛风险增加。治疗前存在焦虑的患者，3 个月后持续性头痛的发生率更高。
