Document Detail

Headaches in patients with radiosurgically treated occipital arteriovenous malformations.
MedLine Citation:
PMID:  10930007     Owner:  NLM     Status:  MEDLINE    
OBJECT: The goal of this study was to determine the prevalence, characteristics, and radiosurgical outcomes of headaches associated with occipital arteriovenous malformations (AVMs). METHODS: The authors reviewed the medical records of 37 consecutive patients with occipital AVMs who had been treated by radiosurgery to identify the radiological features of the AVMs before and after treatment and the clinical features and outcomes of headaches described in accordance with the criteria of the International Headache Society (IHS). Thirty-six patients (97.3%) were followed for a mean period of 46.6 months. The median volume of the AVMs was 1.9 cm3, to which a mean radiation dose of 21.6 Gy was delivered. In the entire study group, periodic headaches were found in 17 patients (45.9%), of whom seven (18.9%) suffered from migraines with the characteristic visual aura. Migraine was predominantly found in patients with right-sided (p = 0.038) or laterally located (p = 0.025) AVMs. Factors associated with a higher incidence of any type of headache included larger nidus volume (p = 0.02), tortuous change of feeding artery (p = 0.036), and cortical drainage with reflux in the superior sagittal sinus (p = 0.032). The actuarial rate of angiographic obliteration was 71.6% at 3 years. Headaches resolved or improved in 12 (70.6%) of 17 patients, including six (85.7%) of seven with migraine. The outcome of headache closely correlated with the obliteration results of the AVM (p = 0.002). CONCLUSIONS: A portion of occipital AVMs do cause headaches that satisfy the current IHS criteria for migraine, and the prevalence varies by the topography of the lesion. Radiosurgery can resolve headaches in the majority of treated patients.
H Kurita; K Ueki; M Shin; S Kawamoto; T Sasaki; M Tago; T Kirino
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  93     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-08-31     Completed Date:  2000-08-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  224-8     Citation Subset:  AIM; IM    
Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Japan.
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MeSH Terms
Intracranial Arteriovenous Malformations / complications,  surgery*
Middle Aged
Migraine Disorders / epidemiology,  etiology*,  surgery
Occipital Lobe / blood supply*,  surgery
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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