Headache prevalence in the population of L'Aquila (Italy) after the 2009 earthquake

Abstract

Stress induced by the events of daily life is considered a major factor in pathogenesis of primary tension-type headache. Little is known about the impact that could have a more stressful event, like a natural disaster, both in patients with chronic headache, both in people that do not had headache previously. The aim of the present study was to observe the prevalence of headache in the population following the devastating earthquake that affected the province of L'Aquila on April 6, 2009. The study population was conducted in four tent cities (Onna, Bazzano, Tempera-St. Biagio, Paganica). Sanitary access is recorded in the registers of medical triage, in the first 5 weeks, after the April 6, 2009. The prevalence of primary headache presentation was 5.53% (95% CI 4.2-7.1), secondary headache was 2.82% (95% CI 1.9-4.9). Pain intensity, assessed by Numerical Rating Scale score showed a mean value of 7±1.1 (range 4-10). The drugs most used were the NSAIDs (46%) and paracetamol (36%), for impossibility of finding causal drugs. This study shows how more stressful events not only have an important role in determining acute exacerbation of chronic headache, but probably also play a pathogenic role in the emergence of primary headache. Also underlines the lack of diagnostic guidelines or operating protocols to early identify and treat headache in the emergency settings.

Fig. 1

Weekly accesses to AMPs. Black column represented patients already suffering from primary headache, grey column represented subjects hitherto not-headache

Fig. 2

Drugs administered for the treatment of headache (frequency of use, %)

Fig. 3

Trend of NRS score in the first 48 h after treatment. In columns are represented the number of patient. Data are presented as mean ± SD and percentage; *P < 0.001 versus T0; °P = 0.006 T _2h versus T _48h