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Level of headaches after surgical aneurysm clipping decreases significantly faster compared to endovascular coiled patients

Athanasios K. Petridis, Jan F. Cornelius, Marcel A. Kamp, Sina Falahati, Igor Fischer, Hans Jakob Steiger
  • Athanasios K. Petridis
    Department of Neurosurgery, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Germany | opticdisc@aol.com
  • Jan F. Cornelius
    Department of Neurosurgery, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Germany
  • Marcel A. Kamp
    Department of Neurosurgery, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Germany
  • Sina Falahati
    Department of Neurosurgery, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Germany
  • Igor Fischer
    Department of Neurosurgery, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Germany
  • Hans Jakob Steiger
    Department of Neurosurgery, University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Germany

Abstract

In incidental aneurysms, endovascular treatment can lead to post-procedural headaches. We studied the difference of surgical clipping vs. endovascular coiling in concern to post-procedural headaches in patients with ruptured aneurysms. Sixtyseven patients with aneurysmal subarachnoidal haemorrhage were treated in our department from September 1st 2015 - September 1st 2016. 43 Patients were included in the study and the rest was excluded because of late recovery or highgrade subarachnoid bleedings. Twenty-two were surgical treated and twenty-one were interventionally treated. We compared the post-procedural headaches at the time points of 24 h, 21 days, and 3 months after treatment using the visual analog scale (VAS) for pain. After surgical clipping the headache score decreased for 8.8 points in the VAS, whereas the endovascular treated population showed a decrease of headaches of 3.3 points. This difference was highly statistical significant and remained significant even after 3 weeks where the pain score for the surgically treated patients was 0.68 and for the endovascular treated 1.8. After 3 months the pain was less than 1 for both groups with surgically treated patients scoring 0.1 and endovascular treated patients 0.9 (not significant). Clipping is relieving the headaches of patients with aneurysm rupture faster and more effective than endovascular coiling. This effect stays significant for at least 3 weeks and plays a crucial role in stress relieve during the acute and subacute ICU care of such patients.

Keywords

Headache; aneurysm; subarachnoid haemorrhage; surgical clipping; endovascular coiling.

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Submitted: 2016-12-31 11:33:53
Published: 2017-04-28 12:37:03
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Copyright (c) 2017 Athanasios K. Petridis, Jan F. Cornelius, Marcel A. Kamp, Sina Falahati, Igor Fischer, Hans Jakob Steiger

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