Análise dos fatores de risco associados à cefaleia da angiografia cerebral
Data
2022-11-18
Autores
Madeira, Tiago Hilton Vieira 
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Este estudo teve como objetivo avaliar asassociações entre características demográficas, clínicas etécnicas da angiografia cerebral por subtração digital (ACSD) ea ocorrência de cefaleia da angiografia cerebral (CeAC).Métodos: Estudo observacional analítico transversal, comindivíduos que apresentavam indicação de realização de ACSDem caráter eletivo. Após o procedimento, os indivíduos partici-param de uma entrevista clínica, para avaliar a ocorrência deCeAC. Entre o terceiro e o sétimo dia, uma nova entrevista foirealizada por telefone, para confirmar ou excluir definitivamentea CeAC. Resultados: Um total de 114 indivíduos submetidos àangiografia cerebral atenderam aos critérios de inclusão do es-tudo. Entre eles, a idade média foi de 52,8 (±13,8) anos, 75,4%(86/114) eram mulheres, 29,8% (34/114) apresentavam an-tecedente de enxaqueca e 10,5% (12/114) de cefaleia crônica. Afrequência de CeAC foi de 45,6% (52/114). Desses, 88,4%(46/52) haviam sido submetidos à angiografia 3D, 7,7% (4/52) àaortografia e 1,9% (1/52) a ambas. No modelo multivariado deregressão logística binária, houve associação estatisticamentesignificante entre a CeAC e os seguintes fatores: antecedentede enxaqueca (OR 4,9; IC 95% 1,62-14,7; p = 0,005) e an-giografia 3D (OR 6,62; IC 95% 2,04-21,5; p = 0,002).Conclusões: O estudo constatou que a angiografia 3D estáfortemente associada à ocorrência de CeAC, dado inédito na lit-eratura. A associação entre um antecedente de enxaqueca e aocorrência de CeAC confirma os resultados de estudos anterior-mente publicados. Ressalta-se que, por se tratar de um estudotransversal, a verdadeira causalidade ainda não pode serdefinida.
Introduction: This study aimed to assess the associations amongdemographic, clinical, and technical characteristics of digital sub-traction angiography (DSA) itself and the occurrence of angiog-raphy headache (AH). Methods: This was an observational ana-lytical cross-sectional study. Subjects who had already been rec-ommended for elective DSA were included. After the procedure,the subjects participated in a clinical interview to assess the oc-currence of AH. Between the third and seventh days, a new in-terview was conducted by telephone to confirm or definitively ex-clude AH. Results: A total of 114 subjects who underwent cere-bral angiography met the study's inclusion criteria. Among them,the mean (SD) age was 52.8 (± 13.8), 75.4% (86/114) werewomen, 29.8% (34/114) had a history of migraines, and 10.5%(12/114) had chronic headaches. The overall frequency of AHwas 45.6% (52/114). Of those, 88.4% (46/52) underwent 3D an-giography, 7.7% (4/52) underwent aortography, and 1.9% (1/52)had both procedures. In the multivariate binary logistic regres-sion model, there was a statistically significant association be-tween AH and the following factors: previous history of migraine(OR 4.9; 95% CI 1.62-14.7; p = 0.005) and 3D angiography (OR6.62; 95% CI 2.04-21.5; p = 0.002). Conclusions: Our studyfound that 3D angiography is strongly associated with the occur-rence of AH, which is unprecedented in the literature. The asso-ciation between a previous history of migraine and AH confirmsthe results of previous studies. As this is a cross-sectional study,true causality may not be defined yet.
Introduction: This study aimed to assess the associations amongdemographic, clinical, and technical characteristics of digital sub-traction angiography (DSA) itself and the occurrence of angiog-raphy headache (AH). Methods: This was an observational ana-lytical cross-sectional study. Subjects who had already been rec-ommended for elective DSA were included. After the procedure,the subjects participated in a clinical interview to assess the oc-currence of AH. Between the third and seventh days, a new in-terview was conducted by telephone to confirm or definitively ex-clude AH. Results: A total of 114 subjects who underwent cere-bral angiography met the study's inclusion criteria. Among them,the mean (SD) age was 52.8 (± 13.8), 75.4% (86/114) werewomen, 29.8% (34/114) had a history of migraines, and 10.5%(12/114) had chronic headaches. The overall frequency of AHwas 45.6% (52/114). Of those, 88.4% (46/52) underwent 3D an-giography, 7.7% (4/52) underwent aortography, and 1.9% (1/52)had both procedures. In the multivariate binary logistic regres-sion model, there was a statistically significant association be-tween AH and the following factors: previous history of migraine(OR 4.9; 95% CI 1.62-14.7; p = 0.005) and 3D angiography (OR6.62; 95% CI 2.04-21.5; p = 0.002). Conclusions: Our studyfound that 3D angiography is strongly associated with the occur-rence of AH, which is unprecedented in the literature. The asso-ciation between a previous history of migraine and AH confirmsthe results of previous studies. As this is a cross-sectional study,true causality may not be defined yet.
Descrição
Citação
MADEIRA, T H V. Análise dos fatores de risco associados à cefaleia da angiografia cerebral. São Paulo, 2022. 107 f. Tese (Doutorado em Neurologia e Neurociências) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP). São Paulo, 2022.