Focal headache during balloon inflation in the internal carotid and middle cerebral arteries

Fenwick T. Nichols, Michel Mawad, J. P. Mohr, Bennett Stein, Sadek Hilal, W. Jost Michelsen

Research output: Contribution to journalArticle

91 Scopus citations

Abstract

Although a number of reports are available on the occurrence of headache in patients with ischemic cerebrovascular disease, most studies have recorded the frequency but not the specific sites of the pain. We report 18 patients who underwent balloon inflation in the distal internal carotid artery and middle cerebral artery stem during embolization therapy for intracerebral arteriovenous malformations. Eleven patients had reproducible patterns of headache during balloon inflation. Inflation in the proximal middle cerebral artery stem produced pain primarily in the ipsilateral temple, that In the middle of the middle cerebral artery stem produced pain referred primarily retro-orbitally, and inflation In the distal middle cerebral artery stem produced pain referred primarily to the forehead. Experimental studies have demonstrated similar patterns of referred pain. The fact that these areas of referred pain are so reproducible is of potentially great clinical importance in the approach to management of patients with cerebrovascular disease.

Original languageEnglish (US)
Pages (from-to)555-559
Number of pages5
JournalStroke
Volume21
Issue number4
DOIs
StatePublished - Apr 1990

Keywords

  • Arteriovenous
  • Embolizations
  • Headache
  • Malformations
  • Therapeutic

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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