The following is a summary of “A comprehensive analysis of patients with cerebral arteriovenous malformation with headache: assessment of risk factors and treatment effectiveness,” published in the May 2024 issue of Pain by Zhang et al.

To improve understanding of headaches in arteriovenous malformation (AVM) given the limited research despite its prevalence.

Researchers conducted a retrospective study to identify risk factors for headaches in patients with AVM and assess the effectiveness of intervention treatments compared to conservative management in reducing headache symptoms.

They conducted a retrospective analysis of AVM cases treated (August 2011 to December 2021). Multivariable logistic regression was employed to evaluate headache risk factors in unruptured, non-epileptic AVMs. Additionally, the effectiveness of various interventions compared to conservative management in relieving headaches was assessed using propensity score matching (PSM).

The results showed that 946 patients were analyzed for headache risk factors. Female gender (OR 1.532, 95% CI 1.173–2.001, P=0.002), supply artery dilatation (OR 1.423, 95% CI 1.082–1.872, P=0.012), and occipital lobe location (OR 1.785, 95% CI 1.307–2.439, P<0.001) were independent headache risk factors. Among 443 AVM cases with headaches, microsurgery (OR 7.27, 95% CI 2.82–18.7, P<0.001), stereotactic radiosurgery (OR 9.46, 95% CI 2.26–39.6, P=0.002), and multimodality treatment (OR 8.34, 95% CI 2.87–24.3, P<0.001) showed significant headache relief post-propensity score matching. However, there was no significant difference between embolization (OR 2.24, 95% CI 0.88–5.69, P=0.091) and conservative management.

Investigators concluded that patients with AVM with identified risk factors benefited significantly from microsurgery, stereotactic radiosurgery, or multimodal therapy compared to conservative management in achieving headache relief.

Source: thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-024-01774-7