Migraine before rupture of intracranial aneurysms

In a prospective case--control study 199 consecutive patients with SIA (103 females and 96 males, mean age: 43.2 years). All were admitted to hospital mostly because of rupture (177) or for unruptured aneurysm (22). In parallel we interviewed 194 blood donors (86 females, 108 males, mean age: 38.4 years) using a semistructured face to face interview by a neurologist. It was focusing on past headaches. Diagnoses were made according to the International Headache Society criteria. Aneurysms were diagnosed by conventional cerebral angiography.During the year before rupture, 124 (62.3%) had one or more types of headache. These headaches included: migraine without aura (MO): 78 (39.2%), migraine with aura (MA): 2 (1%), probable migraine (PM): 4 (2%), tension-type headache (TTH): 39 (19.6%), cluster headache (CH): 2 (1%), posttraumatic headaches (PH): 2 (1%). 1-year prevalence of headaches in controls was 32.5% (63 patients out of 194), they included: TTH: 45 (23.1%), MO: 17(8.8%), PH: 1(0.5%). Only the prevalence of MO was significantly higher in patients with SIA (OR 6.7, 95% CI 3.8-11.9, p < 0.0001).Unruptured SIA cause a marked increase in the prevalence of migraine without aura but not in the prevalence of other types of headache.