Postcraniotomy Headache: Etiologies and Treatments

Bello, Corina; Andereggen, Lukas; Luedi, Markus M.; Beilstein, Christian M.

doi:10.1007/s11916-022-01036-8

Cited by 17 publications

(16 citation statements)

References 65 publications

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“…38 The mechanism for triggering chronic HA after ICP elevation with both atraumatic and TBI may be through dural irritation with meningeal nociceptors located in the dura mater encephali. 39 Cranial surgery has a known association with HA in the acute time frame, 40 and we demonstrated for the first time that it is associated with chronic HA after TBI, although the ORs were not particularly strong. For craniectomy, cranioplasty is shown to help HA after TBI and may have been performed before followup, thus contributing to the low OR.…”

Section: Discussionmentioning

confidence: 59%

What Are the Predictors for and Psychosocial Correlates of Chronic Headache After Moderate to Severe Traumatic Brain Injury?

Walker,

Perera,

Hammond

et al. 2023

Journal of Head Trauma Rehabilitation

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Objective: Although headache (HA) is a common sequela of traumatic brain injury (TBI), early predictors of chronic HA after moderate to severe TBI are not well established, and the relationship chronic HA has with psychosocial functioning is understudied. Thus, we sought to (1) determine demographic and injury predictors of chronic HA 1 or more years after moderate to severe TBI and (2) examine associations between chronic HA and psychosocial outcomes. Setting: Community. Participants: Participants in the TBI Model System (TBIMS) with moderate to severe TBI who consented for additional chronic pain questionnaires at the time of TBIMS follow-up. Design: Multisite, observational cohort study using LASSO (least absolute shrinkage and selection operator) regression for prediction modeling and independent t tests for psychosocial associations. Main Outcome Measure(s): Chronic HA after TBI at year 1 or 2 postinjury and more remotely (5 or more years). Results: The LASSO model for chronic HA at 1 to 2 years achieved acceptable predictability (cross-validated area under the curve [AUC] = 0.70). At 5 or more years, predictability was nearly acceptable (cross-validated AUC = 0.68), but much more complex, with more than twice as many variables contributing. Injury characteristics had stronger predictive value at postinjury years 1 to 2 versus 5 or more years, especially sustained intracranial pressure elevation (odds ratio [OR] = 3.8) and skull fragments on head computed tomography (CT) (OR = 2.5). Additional TBI(s) was a risk factor at both time frames, as were multiple socioeconomic characteristics, including lower education level, younger age, female gender, and Black race. Lower education level was a particularly strong predictor at 5 or more years (OR up to 3.5). Emotional and participation outcomes were broadly poorer among persons with chronic HA after moderate to severe TBI. Conclusions: Among people with moderate to severe TBI, chronic HA is associated with significant psychosocial burden. The identified risk factors will enable targeted clinical screening and monitoring strategies to enhance clinical care pathways that could lead to better outcomes. They may also be useful as stratification or covariates in future clinical trial research on treatments.

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Section: Discussionmentioning

confidence: 59%

What Are the Predictors for and Psychosocial Correlates of Chronic Headache After Moderate to Severe Traumatic Brain Injury?

Walker,

Perera,

Hammond

et al. 2023

Journal of Head Trauma Rehabilitation

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“…Preoperative anxiety and depression have been shown to increase the risk of post-craniotomy pain [ 6 – 8 , 18 ]. Although the preoperative mental health score showed a significant between-group difference in the univariate analysis, there was no significant relationship in the multivariate analyses.…”

Section: Discussionmentioning

confidence: 99%

“…Craniotomy is widely performed for brain tumors and cerebral aneurysms; however, a recent study revealed that the incidence of persistent pain after craniotomy, which was defined as a pain numeric rating scale (NRS) score ≥ 1 after 1 year, was approximately 4.5% and was ranked within the top 10 [ 2 ]. Factors related to acute pain after craniotomy include preoperative depression and anxiety, infratentorial craniotomy, and extended surgical duration [ 6 – 8 ]. Although there have been studies on persistent incisional pain after craniotomy [ 2 , 8 ], the factors associated with it remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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Persistent incisional pain at 1 year after craniotomy: a retrospective observational study

et al. 2023

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Background There have been few reports on persistent incisional pain at 1 year after craniotomy. Hence, this study aimed to explore the distribution of pain at 1 year after elective craniotomy and its related factors. Methods This retrospective study included data prospectively collected to assess postoperative functional disability. We included patients aged > 55 years at the time of recruitment for our initial study and who had complete data regarding the pain numeric rating scale (NRS) score at 1 year post craniotomy. The primary outcome was the pain NRS score, which was assessed at the postanesthetic clinic as well as at 3 months and 1 year after craniotomy. Multivariable negative binomial regression analysis was performed to analyze the relationship between the pain NRS score at 1 postoperative year and 12 clinically meaningful covariates. These included the Short Form-8 scores for bodily pain and mental health, with higher scores indicating better health. Results We analyzed data from 102 patients. The mean (95% confidence interval) pain NRS scores at the three measurement points were 2.8 (2.3–3.3), 1.2 (0.8–1.6), and 0.6 (0.3–0.8), respectively. Multivariable analysis revealed that preoperative bodily pain (risk ratio, 0.93; 95% confidence interval, 0.88–0.98) and the pain NRS score at the postanesthetic clinic (risk ratio, 1.32; 95% confidence interval, 1.14–1.52) were associated with the risk of persistent pain at 1 postoperative year. Conclusions The pain score at 1 year after elective craniotomy was minor; however, preoperative bodily pain and postoperative pain scores were significantly related factors.

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“…There is also a potential role of catecholaminergic nerves in patients suffering from chronic pain. 76…”

Section: Chronic Post-craniotomy Painmentioning

confidence: 99%

Post-craniotomy Pain: An Update

Samagh

Jangra

Dey

2023

J Neuroanaesth Crit Care

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Approximately two-thirds of patients experience moderate to severe intensity pain following craniotomy. It is often undertreated due to fear of unfavorable side effects of commonly used analgesic drugs. The objectives of this review are to discuss the various aspects of acute and chronic post-craniotomy pain including its incidence, pathophysiology, diagnostic criteria, preventive strategies, and management in adult patients. The data have been consolidated based on our literature search from 1978 to 2021 using various databases including Google Scholar, Medline, and PubMed Central. We conclude that one must act at the earliest using various treatment modalities for post-craniotomy pain management.

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Postcraniotomy Headache: Etiologies and Treatments

Cited by 17 publications

References 65 publications

What Are the Predictors for and Psychosocial Correlates of Chronic Headache After Moderate to Severe Traumatic Brain Injury?

What Are the Predictors for and Psychosocial Correlates of Chronic Headache After Moderate to Severe Traumatic Brain Injury?

Persistent incisional pain at 1 year after craniotomy: a retrospective observational study

Post-craniotomy Pain: An Update

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