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Open Access Research article

Migraine before rupture of intracranial aneurysms

Elena R Lebedeva1*, Natalia M Gurary1, Vladimir P Sakovich1 and Jes Olesen2

Author Affiliations

1 Department of Neurology and Neurosurgery, The Urals State Medical Academy, 124 Chkalova str., ap.94, Yekaterinburg, Russia

2 Department of Neurology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark

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The Journal of Headache and Pain 2013, 14:15  doi:10.1186/1129-2377-14-15

Published: 20 February 2013

Abstract

Background

Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA.

Methods

In a prospective case–control study 199 consecutive patients with SIA (103 females and 96 males, mean age: 43.2 years) received a semistructured face to face interview focusing on past headaches. All were admitted to hospital mostly because of rupture (177) or for unruptured aneurysm (22). In parallel we interviewed 194 blood donors (86 females, 108 males, mean age: 38.4 years). Diagnoses were made according to the International Headache Society criteria. Aneurysms were diagnosed by conventional cerebral angiography.

Results

During the year before rupture, 124 (62.3%) had one or more types of headache. These headaches included: migraine without aura (MO): 78 (39.2%), migraine with aura (MA): 2 (1%), probable migraine (PM): 4 (2%), tension-type headache (TTH): 39 (19.6%), cluster headache (CH): 2 (1%), posttraumatic headaches (PH): 2 (1%). 1-year prevalence of headaches in controls was 32.5% (63 patients out of 194), they included: TTH: 45 (23.1%), MO: 17(8.8%), PH: 1(0.5%). Only the prevalence of MO was significantly higher in patients with SIA (OR 6.7, 95% CI 3.8-11.9, p < 0.0001).

Conclusions

Unruptured SIA cause a marked increase in the prevalence of migraine without aura but not in the prevalence of other types of headache.

Keywords:
Migraine; Headache; Risk factor; Intracranial aneurysm; Unruptured aneurysm; Subarachnoid heamorrhage