Chronic headaches and middle meningeal artery embolization

Authors

Joshua S. Catapano, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Katherine Karahalios, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Visish M. Srinivasan, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Jacob F. Baranoski, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Caleb Rutledge, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Tyler S. Cole, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Andrew F. Ducruet, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Felipe C. Albuquerque, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Ashutosh P. Jadhav, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA neuropub@barrowneuro.org.Follow

Document Type

Article

Abstract

BACKGROUND: The middle meningeal artery (MMA) has been implicated in chronic headaches, but no studies have examined the relationship between MMA embolization and headaches. METHODS: Patients treated with MMA embolization for a chronic subdural hematoma (cSDH) between January 1, 2018, and December 31, 2020, were retrospectively assessed. Patients with a Glasgow Coma Scale (GCS) score of 15 at discharge received a follow-up telephone call to assess their history of chronic headache, defined as a headache ≥2 years before the cSDH and symptoms ≥2 days/month. A Headache Impact Test (HIT-6) was performed during the follow-up telephone call. The primary outcome was resolution or improvement of headaches after embolization. RESULTS: Of 76 patients undergoing MMA embolization for a cSDH during the study period, 56 (74%) had a discharge GCS score of 15. Of these 56 patients, 46 (82%) responded to a follow-up telephone call and were analyzed (mean [SD] age 68 [11] years; 36 [78%] men and 10 [22%] women). Nine (20%) reported chronic headaches before embolization. With a mean (SD) follow-up of 489 (173) days, eight of the nine patients reported improvement of chronic headaches, with seven having complete resolution. For these nine patients, the mean (SD) HIT-6 score was significantly higher before embolization than after embolization (64 [7.1] vs 40 [9.1], p<0.001). CONCLUSION: In patients with chronic headaches who underwent MMA embolization for a cSDH, the majority reported improvement of headaches after the procedure. Future prospective studies are warranted to assess the usefulness of MMA embolization to treat chronic headaches.

Keywords

angiography, subdural

Medical Subject Headings

Aged; Embolization, Therapeutic (methods); Female; Headache Disorders (etiology, therapy); Hematoma, Subdural, Chronic (diagnostic imaging, therapy); Humans; Male; Meningeal Arteries (diagnostic imaging); Retrospective Studies; Treatment Outcome

Publication Date

3-1-2022

Publication Title

Journal of neurointerventional surgery

E-ISSN

1759-8486

Volume

14

Issue

3

First Page

301

Last Page

303

PubMed ID

33888570

Digital Object Identifier (DOI)

10.1136/neurintsurg-2021-017602

Recommended Citation

Catapano, Joshua S.; Karahalios, Katherine; Srinivasan, Visish M.; Baranoski, Jacob F.; Rutledge, Caleb; Cole, Tyler S.; Ducruet, Andrew F.; Albuquerque, Felipe C.; and Jadhav, Ashutosh P., "Chronic headaches and middle meningeal artery embolization" (2022). Translational Neuroscience. 2246.
https://scholar.barrowneuro.org/neurobiology/2246