Persistent Headache after Supratentorial Craniotomy

Kaur, Amrit; Selwa, Linda M.; Fromes, Gail; Ross, Donald A.

doi:10.1227/00006123-200009000-00020

Cited by 15 publications

(15 citation statements)

References 15 publications

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“…The incidence of PCH is highly variable (0-75%), most of the studies showing values > 40% (1)(2)(3)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). This variability is probably due to the lack of uniform diagnostic criteria and the retrospective nature of most of the reports in the literature.…”

Section: Introductionmentioning

confidence: 99%

Post-craniotomy headache: A proposed revision of IHS diagnostic criteria

et al. 2009

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Seventy-nine patients with intracranial aneurysms were evaluated in the presurgical period, and followed up to 6 months after surgery. We compare patients who fulfilled with those that did not post-craniotomy headache (PCH) diagnostic criteria, according to the International Classification of Headache Disorders. Semistructured interviews, headache diaries, Short Form-36 and McGill Pain Questionnaire were used. Seventy-two patients (91%) had headaches during the follow-up period. The incidence of PCH according to the International Headache Society diagnostic criteria was 40%. Age, sex, type of surgery, temporomandibular disorder, vasospasm, presence and type of previous headaches, and subarachnoid haemorrhage were not related to headache classification. There were no differences in the quality of life, headache frequency and characteristics or pain intensity between patients with headache that fulfilled or not PCH criteria. We proposed a revision of the diagnostic criteria for PCH, extending the headache outset after surgery from 7 to 30 days, and including the presence of headaches after surgery in patients with no past history of headaches, or an increase in headache frequency during the first 30 days of the postsurgical period followed by a decrease over time. Using these criteria we would classify 65% of our patients as having PCH.

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Section: Introductionmentioning

confidence: 99%

Post-craniotomy headache: A proposed revision of IHS diagnostic criteria

et al. 2009

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“…Headache is a common complication following most surgical procedures involving the head and neck. Headache has been well established as a common complaint following resection of acoustic neuromas or other tumors involving the cerebellopontine angle 1‐7 . The incidence of headache following this type of surgery has been reported to be as high as 75% 4 …”

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confidence: 99%

Postcraniotomy Headache

2003

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“…Common factors associated with other types of surgery include the intensity of postoperative pain and nerve injury. After supratentorial surgery, the prevalence of headache one year following surgery was 11% [27]. This is lower than seen with posterior fossa procedures, where the prevalence of headache one year after surgery is reported to be about 30% [28,29].…”

Section: Pain and Intracranial Surgerymentioning

confidence: 80%

The Perioperative Management of Pain from Intracranial Surgery

Gottschalk

Yaster

2008

Neurocrit Care

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Analgesic therapy following intracranial procedures remains a source of concern and controversy. Although opioids are the mainstay of the "balanced" general anesthetic techniques frequently used during intracranial procedures, neurosurgeons and others have been reluctant to administer opioid analgesics to patients following such procedures. This practice is supported by the concern that the sedation and miosis associated with opioid administration could mask the early signs of intracranial catastrophe, or even exacerbate it through decreased ventilatory drive, elevated arterial carbon dioxide levels, and increased cerebral blood flow. This reluctance to use opioids following intracranial surgery is enabled by decades of training and anecdote emphasizing that pain is minimal following these procedures. However, recent data suggests otherwise, and raises the question of how to provide safe and effective analgesia for these patients. Here, this data is reviewed along with the relevant pain pathways, analgesic drugs and techniques, and the available data on their use following intracranial surgery. Although pain following intracranial surgery appears to be more intense than initially believed, it is readily treated safely and effectively with techniques that have proven useful following other types of surgery, including patient-controlled administration of opioids. The use of multimodal analgesic therapy is emphasized not only for its effectiveness, but to reduce dosages and, therefore, side effects, primarily of the opioids, that could be of legitimate concern to physicians and affect the comfort of their patients.

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Persistent Headache after Supratentorial Craniotomy

Cited by 15 publications

References 15 publications

Post-craniotomy headache: A proposed revision of IHS diagnostic criteria

Post-craniotomy headache: A proposed revision of IHS diagnostic criteria

Postcraniotomy Headache

The Perioperative Management of Pain from Intracranial Surgery

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