Zeenat Qureshi Stroke Institute, St. Cloud, MN, USA.
University of Illinois and Mercyhealth, Rockford, IL, USA.
Headache. 2018 Sep;58(8):1219-1224. doi: 10.1111/head.13377. Epub 2018 Aug 16.
No reliable estimates of headaches following catheter-based cerebral angiography are available. We performed an observational cohort study to ascertain the frequency and type of headaches following catheter-based cerebral angiography.
Consecutive patients who underwent cerebral angiography through the transfemoral (or infrequently radial) route were included. Each patient underwent a brief neurological assessment after the procedure and more detailed assessment was performed if any patient reported occurrence of a headache. The headaches were classified as migraine if the diagnostic criteria specified by International Headache Society were met. The headache severity was classified using a visual numeric rating scale and time to reach pain free status for 2 consecutive hours was ascertained.
Migraine headaches occurred in 5 (3.1%, 95% confidence interval [CI] 1.0-7.2%) of 158 patients who underwent cerebral angiography. The median severity of migraine headaches was 10/10 and time to resolution of headaches was 120 minutes (range 60-360 minutes). Migraine headaches occurred in 4 (18.1%, 95% CI 5.2-40.3%) of 22 patients with a history of migraine and 4 (23.5%, 95% CI 6.8-50%) of 17 patients with regular migraine headaches (≥1 episodes per month). Headaches occurred in 6 (3.8%, 95% CI 1.8-8.0%) patients who did not meet the criteria for migraine headaches.
We provide occurrence rates of migraine headaches, an under-recognized adverse event, in patients undergoing catheter-based cerebral angiography.
目前尚无可靠数据可用于评估经导管脑血管造影术后头痛的发生情况。我们进行了一项观察性队列研究,以确定经导管脑血管造影术后头痛的频率和类型。
连续纳入接受经股动脉(或偶尔经桡动脉)入路进行脑血管造影的患者。每位患者在手术后接受简短的神经学评估,如果有患者报告头痛发生,则进行更详细的评估。如果符合国际头痛协会的诊断标准,则将头痛归类为偏头痛。使用视觉模拟评分法对头痛严重程度进行分类,并确定达到连续 2 小时无痛状态的时间。
158 例行脑血管造影的患者中有 5 例(3.1%,95%置信区间 [CI] 1.0-7.2%)发生偏头痛。偏头痛头痛的中位数严重程度为 10/10,头痛缓解时间为 120 分钟(范围 60-360 分钟)。有偏头痛病史的 22 例患者中有 4 例(18.1%,95%CI 5.2-40.3%)发生偏头痛,17 例有规律偏头痛(每月发作≥1 次)的患者中有 4 例(23.5%,95%CI 6.8-50%)发生偏头痛。6 例(3.8%,95%CI 1.8-8.0%)不符合偏头痛头痛标准的患者发生头痛。
我们提供了经导管脑血管造影术后偏头痛头痛(一种被低估的不良事件)的发生率数据。