Post-Craniotomy Headache: Characteristics, Behaviour and Effect on Quality of Life in Patients Operated for Treatment of Supratentorial Intracranial Aneurysms

Abstract

We prospectively studied headache characteristics during 6 months after craniotomy performed for treatment of cerebral aneurysms in 79 patients. Semistructured interviews, headache diaries, the Hospital Anxiety and Depression Scale and the Epworth Sleepiness Scales, the Short Form-36 Health Survey (SF-36) and McGill Pain Questionnaire were used. Seventy-two patients had headaches, half before the fifth day after surgery. Changes were observed in headache diagnosis, side and site in the postoperative period. Headache frequency increased immediately after surgery and then decreased over time. Headache frequency was associated with depressive and anxiety symptoms. Pain intensity was higher in women and in patients with more anxiety symptoms. An incidence of post-craniotomy headache of 40% was observed according to International Headache Society classification criteria, 10.7% of the acute and 29.3% of the chronic type. The bodily pain domain of the SF-36 was worse in patients with more anxiety symptoms. Greater frequencies of headache were associated with lower scores on bodily pain and social functioning.

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

“…We observed an incidence of PCH of 40% in patients surgically treated for intracranial aneurysms, according to IHS criteria (5). As far as we know, the clinical usefulness of this classification has not been tested.…”

Factors associated with anxiety and depression in the management of acoustic neuroma patients

“…4 It is therefore important to investigate anxiety and depression in this patient group, given that the individual symptoms associated with acoustic neuromas have been related to these outcomes in other patient groups. [5][6][7][8][9][10][11][12][13][14][15][16][17] For example, elevated levels of anxiety and/or depression have been found in patients with tinnitus, [9][10][11][12] hearing loss, 8,13,14 facial paralysis, 15 headaches, 6,7,16 and dizziness and vertigo. 5,17 Given that most acoustic neuroma patients typically experience many of these physical symptoms before or after active management, 18 it is likely that the burden of multiple impairments would increase the risk of anxiety and depression in this population.…”

Technical aspects of decompressive craniectomy for malignant middle cerebral artery infarction

“…Chronic pain is a well recognized complication of craniotomy and can be a cause of significant morbidity. 34,35 3. Conclusions MMI should be considered a non-resectable expanding surgical mass lesion.…”

“…Supine positioning and intravenous fluid hydration can help re-expand the brain and reverse symptoms and neurological deficits before craniectomy. 35 Decompressive craniectomy patients need regular clinical monitoring for the development of SSF. Theoretically, it might be possible to prevent SSF by leaving a floating, hinged bone flap in place at the time of decompression.…”