6.7.1 Headache attributed to an intracranial endarterial procedure

Description:

Unilateral headache caused directly by an intracranial endarterial procedure, ipsilateral to the procedure and lasting less than 24 hours.

Diagnostic criteria:
  1. Any new headache fulfilling criterion C
  2. An intracranial endarterial procedure has been performed1
  3. Evidence of causation demonstrated by at least three of the following:
    1. headache has developed within 1 week of the procedure
    2. headache has resolved within 1 month after the procedure
    3. headache is ipsilateral to the procedure, or bilateral
    4. headache has one of the following sets of characteristics2:
      • a) severe, occurring abruptly within seconds of the procedure and lasting <1 hour
      • b) moderate to severe, developing within hours of the procedure and lasting >24 hours
      • c) occurring in a patient with 1. Migraine and having the features of 1.1 Migraine without aura or 1.2 Migraine with aura
  4. Not better accounted for by another ICHD-3 diagnosis3.
Notes:
  1. For example, angioplasty, embolization or stent placement.
  2. There are three recognized (but not separately coded) subforms of 6.7.1 Headache attributed to an intracranial endarterial procedure:
    • a) a very specific subform reported after balloon inflation or embolization of an AVM or aneurysm: severe pain localized according to the artery involved, developing abruptly within a few seconds of the procedure, and disappearing rapidly;
    • b) headache developing within hours to one day following the procedure and lasting a few days;
    • c) a migraine attack, occurring in a person who has 1. Migraine and triggered by the intracranial endarterial procedure; this is sometimes followed by recurrent intermittent headache during several weeks (in these cases, the patient should have both diagnoses: the appropriate type or subtype of 1. Migraine and 6.7.1 Headache attributed to an intracranial endarterial procedure).
  3. In particular, arterial dissection and arterial rupture have been excluded by appropriate investigations.