6.7.2 Angiography headache


Headache caused directly by cerebral angiography.

Diagnostic criteria:
  1. Any new headache fulfilling criterion C
  2. Intra-arterial carotid or vertebral angiography has been performed
  3. Evidence of causation demonstrated by at least two of the following:
    1. headache has developed during or within 24 hours of the angiography
    2. headache has resolved within 72 hours after the angiography
    3. headache has one of the following sets of characteristics1:
      • a) developing during contrast injection and lasting <1 hour
      • b) developing a few hours after the angiography 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 diagnosis.

There are three recognized (but not separately coded) subforms of 6.7.2 Angiography headache.

  1. occurring during angiography, and closely related to contrast injection;
  2. occurring later, but within 24 hours;
    (both these subforms are more common in patients with a history of primary headache, but are distinctly different in character from the primary headache);
  3. Migraine and triggered by angiography (in these cases, the patient should have both diagnoses: the appropriate type or subtype of 1. Migraine and 6.7.2 Angiography headache).

Contrast angiography is contraindicated in patients affected by any subform of 1.2.3 Hemiplegic migraine because it may trigger a life-threatening attack, with prolonged hemiplegia and coma.