LOS ANGELES – Visual disturbances reported by patients after foam sclerotherapy are migrainous aura and should not be confused with cerebrovascular events, a small, prospective, multicenter study suggests.
In the study, a headache specialist analyzed questionnaires that were completed by 20 consecutive patients who reported visual disturbances after undergoing foam sclerotherapy at 11 French outpatient phlebology clinics.
All patients underwent cerebral MRIs within 2 weeks that were interpreted by a radiologist and again by a neuroradiologist.
Dr. Anne Donnet of the Pôle Neurosciences Cliniques at Hôpital Timone, Marseille, France, and her associates concluded that six patients had aura with nonmigrainous headache, five had aura without headache, four patients had the characteristics of aura with migrainous headache, and five did not have a headache or aura classification identified.
Dr. Donnet and her colleagues reported their findings in a poster presentation.
The 20 patients, 16 of whom were women, had an average age of 47 years.
In every case, the foam for sclerotherapy was made with air. The visual disturbance occurred an average of 7 minutes after the end of the injection, and lasted less than 30 minutes in 11 of the 20 patients, the investigators reported.
In 11 patients with headache, the visual disturbance started before a headache in 10 and at the same time in 1. The headache lasted less than 4 hours in six patients, 4-12 hours in one patient, and more than 24 hours in three patients. The duration was not specified for one patient whose headache was slight. Nine patients did not get headaches.
Paresthesia was observed in five patients and dysphasic speech disturbance occurred in one. Other symptoms in 13 patients included nausea in 10, photophobia in 6, phonophobia in 5, and chest pressure in 3.
A total of 15 patients had a personal history of migraine – 13 with aura and 2 without.
In follow-up contacts 2-4 weeks after sclerotherapy, patients said the visual disturbances had been transient and reported no new symptoms.