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Stroke. 2019 Dec;50(12):3628-3631. doi: 10.1161/STROKEAHA.119.026864. Epub 2019 Oct 14.

Headache Outcomes After Treatment of Unruptured Intracranial Aneurysm: A Systematic Review and Meta-Analysis.

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From the Division of Neurosurgery, University of British Columbia, Vancouver, Canada (C.D., S.P., G.R., C.S.H., P.A.G.).
T.H. Chan School of Public Health, Harvard University, Boston, MA (C.D., H.S.P., F.N.).
Division of Otolaryngology - Head and Neck Surgery, University of British Columbia, Vancouver, Canada (H.S.P., E.P.).
Division of Vascular Surgery, McMaster University, Hamilton, Canada (F.N.).


Background and Purpose- While unruptured intracranial aneurysms may be discovered incidentally in the workup of chronic headache, it remains unclear whether their treatment ultimately impacts headache severity. We aim to conduct a systematic review and meta-analysis assessing headache severity after treatment of unruptured intracranial aneurysm. Methods- MEDLINE and EMBASE were systematically reviewed. Results- Data from 7 studies met inclusion criteria (309 nonduplicated patients). The standard mean difference in pre- and post-intervention headache severity was estimated at -0.448 (95% CI, -0.566 to -0.329) under a random effects model. No significant heterogeneity was noted nor was any significant publication bias demonstrated. Conclusions- This is the first systematic review assessing postoperative headache severity following treatment of unruptured intracranial aneurysm. While a significant reduction in headache severity was observed, further investigation into this phenomenon is recommended before it influences clinical practice. Future study should stratify headache outcomes by aneurysm size, location, and treatment modality.


MEDLINE; endovascular procedures; headache; intracranial aneurysm; microsurgery

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