6.3.2 Headache attributed to arteriovenous malformation (AVM)Hartmut Gobel2018-02-06T10:40:38+00:00
Diagnostic criteria:
- Any headache fulfilling criterion C
- An arteriovenous malformation (AVM) has been diagnosed
- Evidence of causation demonstrated by at least two of the following:
- headache has developed in close temporal relation to other symptoms and/or clinical signs of AVM, or has led to the discovery of an AVM
- either or both of the following:
- – headache has significantly worsened in parallel with growth of the AVM
- – headache has significantly improved or resolved in parallel with effective treatment of the AVM
- headache is localized to the site of the AVM
- Not better accounted for by another ICHD-3 diagnosis1.
Note:
In particular, intracranial haemorrhage has been excluded by appropriate investigations.
Comments:
Cases have been reported highlighting the association of arteriovenous malformation (AVM) with different types of 3. Trigeminal autonomic cephalalgias including 3.1 Cluster headache, 3.2.2 Chronic paroxysmal hemicrania and 3.3.1 Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), but these cases had atypical features. There is no good evidence of a relationship between AVM and these primary headache disorders.
1.2 Migraine with aura has been reported in up to 58% of women with AVM. A strong argument in favour of a causal relationship is the overwhelming correlation between the side of the headache, or of the aura, and the side of the AVM. There is thus a strong suggestion that AVM can cause attacks of migraine with aura (symptomatic migraine). Yet in a large AVM series, presenting features frequently included epilepsy or focal deficits with or without haemorrhage and migraine-like symptoms much more rarely.