Turkish Neurosurgery
Effect of size and location of unruptured intracranial aneurysms on self-reported headache
Juan Manuel Marquez-Romero1, Dulce Anabel Espinoza-López 2, Juan Manuel Calleja-Castillo 3, Fernando Zermeño-Pöhls 2, Rogelio Salinas-Gutiérrez 4
1IMSS, Neurology, Aguascalientes,
2Departamento de Neurología, Instituto Nacional de Neurología “Manuel Velasco Suárez”., Neurology, Mexico City,
3Centro Neurológico ABC, Neurology, Mexico City,
4Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Statistics, Aguascalientes,
DOI: 10.5137/1019-5149.JTN.45018-23.2

Aim:To describe the relationship between aneurysm size and location and the prevalence of headache at diagnosis and three-and-six-month follow-up in a sample of patients with UIAs.Material and Methods:In this cohort study, patients were diagnosed with UIAs by digital subtraction angiography. Follow-up visits occurred three and six months after the diagnosis. Headache presence was registered and further classified by phenotypes. After DSA, recorded variables were: aneurysm number, morphology, location, and size (diameter [W], neck [N], and dome-neck distance [H]). The aspect ratio (H/N) and the dome/neck ratio (W/N) were calculated. The outcome of this study was the self-reported headache status at follow-up.Results:Data from 42 patients and 46 aneurysms were available, 81.0% women, with a mean age of 57.4±14.3 years. Headache was reported by 61.9% of the patients. The pain phenotype was tension-type in 38.1%, migraine in 11.9%, neuralgia in 2.4%, and unclassifiable in 9.5%. The median (min-max) measurements were W=5.05 (0.89–22.9); N=3.02 (0.52–17.9); H=5.08 (0.92–23.0); aspect ratio 1.59 (0.68–17.69) and W/N ratio 1.65 (0.62–16.92). Thirty-three patients (37 aneurysms) received treatment, 47.8% by surgical clipping and 32.6% by endovascular occlusion. In treated patients, the headache persisted in 14.3% on the first and 9.5% on the second visit. There were no differences in any registered variables between patients with and without headaches at follow-up.Conclusion:This study found data that supports that headache in patients with UIAs improves after treatment and that such improvement is probably unrelated to the size and shape of the UIAs.

Corresponding author : Juan Manuel Calleja-Castillo