Article
3 months follow-up of subarachnoid haemorrhage headaches after treatment of ruptured aneurysms in interventionally and surgically treated patients
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Published: | June 9, 2017 |
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Objective: We studied the difference of surgical “clipping” vs. endovascular “coiling” in concern to post-procedural headaches in patients with ruptured aneurysms.
Methods: Retrospective analysis of N=43 patients with aneurysmal subarachnoidal haemorrhage treated in our department from September 1st 2015 - September 1st 2016 with a WFNS of 1-3. N=22 were surgically treated and N=21 interventionally. 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.
Results: After surgical treatment the headache decreased for 8.8 points in the VAS, whereas the endovascular treated population showed a decrease of headaches of only 3.3 points (p<0.001). This highly statistical difference remained for 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).
Conclusion: Clipping relieves the patients SAH headaches 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.