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

Abstract

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.

Post‐Craniotomy Headache: A Clinical View With a Focus on the Persistent Form

“…There is a significant change in the headache pattern after craniotomy, in comparison with these patients' previous headaches . There is a significant increase in the frequency of headaches after surgery, and the majority of patients started to have headaches on the same side as and at the site of the surgery …”

“…Using the definition of PCH from the ICHD‐2, which is more restrictive than ICHD‐3, incidence of PCH was found to be 40% to 54.9%, acute PCH 10.7%, and chronic PCH 24% to 29.3% . Using ICHD‐3, the incidence of PCH was found to be 60% …”

“…Patients undergoing neurosurgery to treat intracranial aneurysms have a 2.6‐fold greater chance of having headaches than those who are treated using an endovascular procedure . Studies that evaluate gender, age, and presence of headaches prior to surgery as risk factors for PCH have shown conflicting results .…”

Headache Research and Medical Practice in Brazil: An Historical Overview

“…Our contribution in the study of secondary types of headache is worthy of mention. Several articles have been published by Brazilian authors on headache possibly caused by an intracranial aneurysm . Krymchantowski described the clinical characteristics of the headache triggered by a policeman's helmet.…”

“…Several articles have been published by Brazilian authors on headache possibly caused by an intracranial aneurysm. 51,[282][283][284][285][286] Krymchantowski 287 described the clinical characteristics of the headache triggered by a policeman's helmet. In this connection, our group showed that the use of a ponytail by a woman more easily triggers a headache attack in migraineurs.…”