Factors Associated With Post-craniotomy Headache After Microvascular Decompression in Hemifacial Spasm

Abstract

Objective: Patients who undergo microvascular decompression (MVD) often experience post-craniotomy headache (PCH), while the PCH is always neglected. This study is aimed to describe the natural course and risk factors of PCH. Methods The severity and duration of PCH in 87 patients who undergo MVD were recorded. Factors related to the severity and duration of PCH were analyzed. Results Most patients (63.2%) had at least one assessment of moderate to severe PCH. Almost all patients (92%) would gradually decrease to disappear within 7 days. A small number of patients (25.5%) had PCH at the incision, and other patients had PCH inside the head. Younger age and gas in the prepontine cistern were the salient features of patients in the severe group. Younger, higher SAS, gas in the prepontine cistern area, and postoperative fever were independent risk factors that affect the duration of PCH. Conclusions PCH is the most common and self-limiting complication after MVD among patients with HFS. Young age, temperature > 38˚C after MVD within 24h, and gas around the TN are associated may predict the severity and duration of PCH. Significance This is the first study to describe the severity, duration, location, and risk factors of PCH.