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中国未破裂颅内动脉瘤患者颅内血管内治疗后的头痛改善:一项前瞻性观察研究。

Headache improvement after intracranial endovascular procedures in Chinese patients with unruptured intracranial aneurysm: A prospective observational study.

作者信息

Zhang Linjing, Wang Yunxia, Zhang Qingkui, Ge Wei, Wu Xiancong, Di Hai, Wang Jun, Cao Xiangyu, Li Baomin, Liu Ruozhuo, Yu Shengyuan

机构信息

Department of Neurology, Chinese PLA General Hospital, Beijing, PR China Department of Neurology, the First Hospital Affiliated to the Chinese PLA General Hospital, Beijing, PR China Department of Neurology, Hainan Branch of Chinese PLA General Hospital, Sanya, PR China.

出版信息

Medicine (Baltimore). 2017 Feb;96(6):e6084. doi: 10.1097/MD.0000000000006084.

Abstract

The aim of this study was to investigate whether there is a long-term improvement in headache of patients with unruptured intracranial aneurysms (UIAs) treated with intracranial endovascular procedures.Using a prospective design, consecutive patients with UIAs with neuroendovascular treatment from January 2014 to December 2014 were asked to participate. Headache outcomes were established before aneurysm treatment and for 6 months following treatment. Factors associated with different headache outcomes were investigated.Ultimately, 58 patients completed the 6-month follow-up. In total, 29 patients had preoperative headache. Six months after the intracranial endovascular procedure, 13 patients (44.8%) stated that their headaches were relieved after endovascular treatment; headache in 1 patient improved slightly, and 12 reported disappearance of headache and marked improvement. Overall, the mean headache scores of 29 patients improved on the self-reported Numeric Rating Scale (NRS) after endovascular treatment (6.00 vs. 2.30; P < 0.001). Patients with pretreatment tension-type headache, more severe headaches, stent-assisted coiling, and stent implantation of the aneurysm were the important disadvantage for patients in improvement of post-procedure headache.Treatment of UIAs resulted in relief of headaches in about half of patients who had headaches pre-operatively.

摘要

本研究的目的是调查颅内未破裂动脉瘤(UIA)患者接受颅内血管内治疗后头痛是否有长期改善。采用前瞻性设计,邀请了2014年1月至2014年12月接受神经血管内治疗的连续性UIA患者参与。在动脉瘤治疗前及治疗后6个月确定头痛结果。研究了与不同头痛结果相关的因素。最终,58例患者完成了6个月的随访。共有29例患者术前有头痛。颅内血管内治疗6个月后,13例患者(44.8%)表示血管内治疗后头痛缓解;1例患者头痛略有改善,12例报告头痛消失且有明显改善。总体而言,29例患者经血管内治疗后,自我报告的数字评分量表(NRS)上的平均头痛评分有所改善(6.00对2.30;P<0.001)。治疗前有紧张型头痛、头痛更严重、支架辅助弹簧圈栓塞以及动脉瘤植入支架的患者,术后头痛改善情况较差。UIA的治疗使术前有头痛的患者中约一半的头痛得到缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8474/5313023/990f147edefb/medi-96-e6084-g001.jpg

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