1
|
Lu C, Zhang L, Wang J, Cao X, Jia X, Ma X, Zhang R, Wang L, Yang Y, Meng F, Yu S, Liu R. The applicability research of the diagnostic criteria for 6.7.2 angiography headache in the international classification of headache disorders-3rd edition. J Headache Pain 2022; 23:20. [PMID: 35100967 PMCID: PMC8903541 DOI: 10.1186/s10194-021-01373-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/14/2021] [Indexed: 11/19/2022] Open
Abstract
Background Angiography headache (AH) is common but not negligible, and the criteria for AH have been based on only a few studies. The purpose of this study was to investigate the incidence, risk factors and possible mechanism of AH and reappraise the diagnostic criteria for AH in the International Classification of Headache Disorders 3 (ICHD-3). Methods Two hundred and seventy-nine patients completed this prospective, non-randomized study, including 107 patients who underwent cerebral angiography, 101 patients who underwent coronary intervention and 71 patients who underwent extremities arterial intervention. Patients were followed up with questionnaires immediately after the procedure and 24 h, 72 h, 1 week and 2 weeks after the procedure. Results The incidence of headache was 22.4% (24/107) in cerebral angiography group, 23.8% (24/101) in coronary intervention group, and 16.9% (12/71) in extremities arterial intervention group. Headache still occurred in 12.1% (13/107), 14.9% (15/101) and 11.3% (8/71) of patients 24 h after the procedure in the three groups, respectively. Two types of headache were observed in cerebral angiography group and coronary intervention group, one during and one after the procedure, while only postoperative headache was observed in extremities arterial intervention group. Previous headache history was a risk factor for headache in the three groups (p = 0.003 in cerebral angiography group, p = 0.006 in coronary intervention group, and p = 0.016 in extremities arterial intervention group). In addition, female (p = 0.008) was a risk factor for cerebral angiography group. Headache characteristics were described in detail. Conclusions The diagnostic criteria for 6.7.2 angiography headache in ICHD-3 may miss a number of cerebral AH with onset later than 24 h after the procedure. Therefore, it is recommended to revise it according to the literature and further studies. The incidence of headache was high during and after angiography and interventional procedure. It was suggested that the definition of headache due to coronary intervention and headache due to extremities arterial intervention should be added in ICHD.
Collapse
|
2
|
Qureshi AI, Jahngir MU, Akinci Y, Gao X, Akhtar IN, Kraus J, Singh B, Lobanova I, Uzun G, Balasetti VKS, Liaqat J, French BR, Siddiq F, Gomez CR. Intraprocedural Back Pain Associated with Awake Neuroendovascular Procedures. J Neuroimaging 2020; 31:209-214. [PMID: 33176020 DOI: 10.1111/jon.12801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/25/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND AND PURPOSE The prevalence and characteristics of intraprocedural back pain is not well studied in awake patients undergoing neuroendovascular procedures. METHODS We performed a prospective study as part of quality improvement initiative in which all patients who underwent neuroendovascular procedures in awake state were inquired regarding presence, severity (using a numeric rating scale score ranging from 0 [no pain] to 10 [worst pain possible]), and location (using anatomical chart) of back pain immediately after the procedure. The primary endpoint was the proportion of patients with moderate to severe pain (score of ≥3). RESULTS A total of 100 (41.3%) of 242 patients reported intraprocedural back pain with a median severity of 5/10 (range 1-10). The mean age was 58.7 ± 16.2 years. The mean duration of the procedure was 82.3 minutes (range 15-410 minutes). The pain was classified as moderate to severe in 86 of 100 patients. The locations of pain were identified in lumbar (n = 77), thoracic (n = 6), cervical (n = 7), cervical and lumbar (n = 8), and cervical with thoracolumbar (n = 2) regions. There was a significant relationship between patients' history of the previous neck and/or back surgery and frequency of moderate to severe back pain (P = .02). No significant relationship was observed between frequency of none to mild and moderate to severe back pain among the strata by patients' age, body mass index, or duration of procedures. CONCLUSIONS The relatively high prevalence of intraprocedural back pain in patients undergoing neuroendovascular procedures in awake state must be recognized, and strategies to reduce the occurrence need to be identified.
Collapse
Affiliation(s)
- Adnan I Qureshi
- Zeenat Qureshi Stroke Institute, Columbia, MO.,Department of Neurology, University of Missouri, Columbia, MO
| | | | - Yasemin Akinci
- Zeenat Qureshi Stroke Institute, Columbia, MO.,Department of Neurology, University of Missouri, Columbia, MO
| | - Xiaoyu Gao
- Zeenat Qureshi Stroke Institute, Columbia, MO.,Department of Neurology, University of Missouri, Columbia, MO
| | - Iqra Naveed Akhtar
- Zeenat Qureshi Stroke Institute, Columbia, MO.,Department of Neurology, University of Missouri, Columbia, MO
| | | | - Baljinder Singh
- Zeenat Qureshi Stroke Institute, Columbia, MO.,Department of Neurology, University of Missouri, Columbia, MO
| | - Iryna Lobanova
- Department of Neurology, University of Missouri, Columbia, MO
| | - Guven Uzun
- Zeenat Qureshi Stroke Institute, Columbia, MO.,Department of Neurology, University of Missouri, Columbia, MO
| | | | - Jahanzeb Liaqat
- Zeenat Qureshi Stroke Institute, Columbia, MO.,Department of Neurology, University of Missouri, Columbia, MO
| | - Brandi R French
- Department of Neurology, University of Missouri, Columbia, MO
| | - Farhan Siddiq
- Division of Neurological Surgery, University of Missouri, Columbia, MO
| | - Camilo R Gomez
- Department of Neurology, University of Missouri, Columbia, MO
| |
Collapse
|