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Postangiography Headache
Author(s) -
Ramadan Nabih M.,
Gilkey Stephanie J.,
Mitchell Mary,
Sawaya Kara L.,
Mitsias Panayiotis
Publication year - 1995
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.1995.hed3501021.x
Subject(s) - phonophobia , medicine , photophobia , migraine , nausea , vomiting , anesthesia , headaches , aura , angiography , cerebral angiography , surgery
In order to study the frequency and characteristics of post‐angiography headache, we interviewed 45 consecutive patients (mean age ± SD= 57 ± 15 years; M/F=15/30) who underwent transfemoral cerebral angiography for: ischemic cerebrovascular disease (n=33); suspected arteriovenous malformations (n=4; one confirmed); suspected cerebral aneurysm (n=5; two confirmed); and arterial dissection (n=3; one confirmed and one was a follow‐up study of a previously demonstrated dissection). Postangiography headache developed in 15 (33%) patients, 125 ± 99 min after the completion of the study. It was unilateral in nine (60%) patients, homolateral to the usual side of migraine headache in two of three migraineurs, and pulsating in six (40%). Nausea, vomiting, photophobia, and phonophobia accompanied postangiography headache in 20%, 7%, 33%, and 20% respectively. Postangiography headache fulfilled the International Headache Society criteria for migraine without aura (except for the number of attacks) in 27% of patients. Patients with and those without postangiography headache were comparable in mean age, sex, and indication for angiography. Fifty‐three percent (8/15) of patients with postangiography headache and 23% (7/30) of the non postangiography headache group reported prior recurrent headaches (P =0.047, likelihood ratio chi‐square). Postangiography headache has the characteristics of delayed arterial pain which may be related to a catheter‐induced or contrast dye‐induced release of vasoactive substances, notably nitric oxide and serotonin.